Is intraoperative preparation like rectal washout needed on local excition for early rectal cancer?

Exfoliated cancer cells in the rectum were studied to clarity the possibility of implantation methastasis in early rectal cancer. Twelve patients with rectal cancers and one with sigmoid colon cancer at an early stage who underwent transanal local excision were entred in the study. Cells were collected from three different areas of the mucosa around the tumor (right, left and anal side), and from the center of the tumor before excision. Exfoliated cancer cells were examined cytologically. Scratch cytology was performed from the tumor in 11 of the 13 patients following excision. Exfoliated cancer cells were confirmed in one of 39 specimens collected from the mucosa (2.6 %). Cancer cells were identified in 9 of the 13 patients (69.2 %) by contact cytology. Scratch cytology revealed cancer cells in 10 of the 11 patients (90.9 %). It was considered that intraoperative preparation like rectal washout is not necessary because the possibility of exfoliated cancer cells in the mucosa of the rectum was very low.