Meeting of The American Society of Colon and Rectal Surgeons. Philadelphia, PA, USA, 1997/06/22.
Traumatic manipulation of cancer specimens during laparoscopic colectomy may increase exfoliation of malignant cells into the peritoneal cavity, causing an early occurrence of peritoneal carcinomatosis or port-sites recurrence.
Because of this concern, the routine use of intraperitoneal chemotherapy after laparoscopic colectomy for cancer was suggested recently.
We assessed if laparoscopic vs. conventional surgery increases exfoliated malignant cells in the peritoneal cavity during resection of colorectal cancer.
In a prospective, randomized fashion, 38 colorectal cancer patients undergoing an elective, curative operation were assigned to either a conventional or laparoscopic procedure between June 1996 and May 1997.
In either group (n=19), after the abdominal cavity was entered, saline was instilled into the peritoneal cavity, and the fluid was collected (Specimen 1).
During surgery, all irrigating fluids were collected (Specimen 2).
Both specimens were assessed for malignancy using four techniques : filtration process (ThinPrep), smear, cell block, and immunochemistry using Ber-EP4.
The change in the amount of tumor cells in both specimens was compared between surgical groups.
A pilot study was performed to validate the proposed cytologic method.
In the pilot study of 20 consecutive patients with colorectal cancer, postresectional peritoneal cytology was positive in six patients, including two Stage II (T3, N0, M0) patients. (...)
Mots-clés Pascal : Carcinome, Côlon, Rectum, Résection chirurgicale, Voie abord, Laparotomie, Laparoscopie, Dissémination, Cellule tumorale, Cavité péritonéale, Risque, Etude comparative, Homme, Tumeur maligne, Appareil digestif pathologie, Intestin pathologie, Côlon pathologie, Rectum pathologie, Chirurgie, Endoscopie
Mots-clés Pascal anglais : Carcinoma, Colon, Rectum, Surgical resection, Surgical approach, Laparotomy, Laparoscopy, Dissemination, Tumor cell, Peritoneal cavity, Risk, Comparative study, Human, Malignant tumor, Digestive diseases, Intestinal disease, Colonic disease, Rectal disease, Surgery, Endoscopy
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Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0432255
Code Inist : 002B25G02. Création : 25/01/1999.