Intragastric free cancer cells may be attached to automatic staplers during anastomosis in patients with gastric cancer
Abstract Background Automatic staplers are often used to reconstruct the digestive tract during surgeries for gastric cancer. Intragastric free cancer cells adhering to automatic staplers may come in contact with the laparoscopic port area and progress to port site recurrence. This study aimed to in...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2024-01-01
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| Series: | World Journal of Surgical Oncology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12957-023-03285-2 |
| _version_ | 1797363237237293056 |
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| author | Atsuko Ohki Taisuke Takagi Yohei Kojima Masanao Tsurumi Yoshikazu Hashimoto Hirohisa Takeuchi Hiroshi Kamma Yoshihiro Sakamoto Eiji Sunami Nobutsugu Abe |
| author_facet | Atsuko Ohki Taisuke Takagi Yohei Kojima Masanao Tsurumi Yoshikazu Hashimoto Hirohisa Takeuchi Hiroshi Kamma Yoshihiro Sakamoto Eiji Sunami Nobutsugu Abe |
| author_sort | Atsuko Ohki |
| collection | DOAJ |
| description | Abstract Background Automatic staplers are often used to reconstruct the digestive tract during surgeries for gastric cancer. Intragastric free cancer cells adhering to automatic staplers may come in contact with the laparoscopic port area and progress to port site recurrence. This study aimed to investigate the presence/absence of cancer cells adhering to automatic staplers during gastric cancer surgery using cytological examinations. We further determined the positive predictive clinicopathological factors and clinical implications of free cancer cells attached to automatic staplers. Methods This study included 101 patients who underwent distal gastrectomy for gastric cancer. Automatic staplers used for anastomosis in gastric cancer surgeries were shaken in 150 ml of saline solution to collect the attached cells. Papanicolaou stains were performed. We tested the correlation between cancer-cell positivity and clinicopathological factors to identify risk factors arising from the presence of attached cancer cells to the staplers. Results Based on the cytology, cancer cells were detected in 7 of 101 (6.9%) stapler washing fluid samples. Univariate analysis revealed that circular staplers, type 1 tumors, and positive lymph nodes were significantly associated with higher detection of free cancer cells adhering to staplers. No significant differences in other factors were detected. Of the seven cases with positive cytology, one developed anastomotic recurrence. Conclusions Exfoliated cancer cells adhered to the automatic staplers used for anastomoses in 6.9% of the staplers used for distal gastrectomies in patients with gastric cancer. Staplers used for gastric cancer surgeries should be handled carefully. |
| first_indexed | 2024-03-08T16:18:22Z |
| format | Article |
| id | doaj.art-76a1160198b145869ab200931ed00b4b |
| institution | Directory Open Access Journal |
| issn | 1477-7819 |
| language | English |
| last_indexed | 2024-03-08T16:18:22Z |
| publishDate | 2024-01-01 |
| publisher | BMC |
| record_format | Article |
| series | World Journal of Surgical Oncology |
| spelling | doaj.art-76a1160198b145869ab200931ed00b4b2024-01-07T12:29:00ZengBMCWorld Journal of Surgical Oncology1477-78192024-01-012211810.1186/s12957-023-03285-2Intragastric free cancer cells may be attached to automatic staplers during anastomosis in patients with gastric cancerAtsuko Ohki0Taisuke Takagi1Yohei Kojima2Masanao Tsurumi3Yoshikazu Hashimoto4Hirohisa Takeuchi5Hiroshi Kamma6Yoshihiro Sakamoto7Eiji Sunami8Nobutsugu Abe9Department of Gastroenterological and General Surgery, Kyorin University Faculty of MedicineDepartment of Gastroenterological and General Surgery, Kyorin University Faculty of MedicineDepartment of Gastroenterological and General Surgery, Kyorin University Faculty of MedicineDepartment of Gastroenterological and General Surgery, Kyorin University Faculty of MedicineDepartment of Gastroenterological and General Surgery, Kyorin University Faculty of MedicineDepartment of Gastroenterological and General Surgery, Kyorin University Faculty of MedicineNasu Institute of Medical SciencesDepartment of Gastroenterological and General Surgery, Kyorin University Faculty of MedicineDepartment of Gastroenterological and General Surgery, Kyorin University Faculty of MedicineDepartment of Gastroenterological and General Surgery, Kyorin University Faculty of MedicineAbstract Background Automatic staplers are often used to reconstruct the digestive tract during surgeries for gastric cancer. Intragastric free cancer cells adhering to automatic staplers may come in contact with the laparoscopic port area and progress to port site recurrence. This study aimed to investigate the presence/absence of cancer cells adhering to automatic staplers during gastric cancer surgery using cytological examinations. We further determined the positive predictive clinicopathological factors and clinical implications of free cancer cells attached to automatic staplers. Methods This study included 101 patients who underwent distal gastrectomy for gastric cancer. Automatic staplers used for anastomosis in gastric cancer surgeries were shaken in 150 ml of saline solution to collect the attached cells. Papanicolaou stains were performed. We tested the correlation between cancer-cell positivity and clinicopathological factors to identify risk factors arising from the presence of attached cancer cells to the staplers. Results Based on the cytology, cancer cells were detected in 7 of 101 (6.9%) stapler washing fluid samples. Univariate analysis revealed that circular staplers, type 1 tumors, and positive lymph nodes were significantly associated with higher detection of free cancer cells adhering to staplers. No significant differences in other factors were detected. Of the seven cases with positive cytology, one developed anastomotic recurrence. Conclusions Exfoliated cancer cells adhered to the automatic staplers used for anastomoses in 6.9% of the staplers used for distal gastrectomies in patients with gastric cancer. Staplers used for gastric cancer surgeries should be handled carefully.https://doi.org/10.1186/s12957-023-03285-2Gastric cancerSurgical staplersGastrectomyAnastomosisRecurrence |
| spellingShingle | Atsuko Ohki Taisuke Takagi Yohei Kojima Masanao Tsurumi Yoshikazu Hashimoto Hirohisa Takeuchi Hiroshi Kamma Yoshihiro Sakamoto Eiji Sunami Nobutsugu Abe Intragastric free cancer cells may be attached to automatic staplers during anastomosis in patients with gastric cancer World Journal of Surgical Oncology Gastric cancer Surgical staplers Gastrectomy Anastomosis Recurrence |
| title | Intragastric free cancer cells may be attached to automatic staplers during anastomosis in patients with gastric cancer |
| title_full | Intragastric free cancer cells may be attached to automatic staplers during anastomosis in patients with gastric cancer |
| title_fullStr | Intragastric free cancer cells may be attached to automatic staplers during anastomosis in patients with gastric cancer |
| title_full_unstemmed | Intragastric free cancer cells may be attached to automatic staplers during anastomosis in patients with gastric cancer |
| title_short | Intragastric free cancer cells may be attached to automatic staplers during anastomosis in patients with gastric cancer |
| title_sort | intragastric free cancer cells may be attached to automatic staplers during anastomosis in patients with gastric cancer |
| topic | Gastric cancer Surgical staplers Gastrectomy Anastomosis Recurrence |
| url | https://doi.org/10.1186/s12957-023-03285-2 |
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