Analysis Of Cytological Examination Results Of Peritoneal Lavage Fluid In TaTME And LaTME

Objective To analyze the clinical significance of the results of tumor cytology in the lavage of operation area at the beginning and end of laparoscopic assisted trans-anal total mesorectal excision(TaTME)and trans-abdominal Total mesorectal excision(LaTME).Methods The clinical data of 66 consecutive patients with rectal cancer admitted to the Department of Gastroenterology,the First Affiliated Hospital of Chongqing Medical University from May.2019 to Mar.2020,66 patients were retrospectively analyzed,including 31 patients with TaTME and 35 patients with LaTME.In TaTME group,rectal lavage was collected after anal purse string suture and abdominal lavage was collected at the end of operation;in LaTME group,abdominal lavage was collected at the beginning of operation and at the end of operation.The results of exfoliative cytology were compared between the two groups for statistical analysis.Results In TaTME group,there were 2 cases with positive cytological examination of rectal lavage fluid after purse string suture,the positive rate was 6.45%(2/31),and 6 cases were positive for peritoneal lavage fluid at the end of operation,the positive rate was 19.35%(6 / 31)at the end of operation.In LaTME group,there were 2 patients with peritoneal lavage positive at the beginning of operation,the positive rate was 5.71%(2 / 35),and 4 cases were positive in peritoneal lavage at the end of operation,the positive rate was 11.43%(4/35).There was no significant difference in the positive rate of peritoneal lavage fluid at the beginning of operation and after operation(P>0.05).The the distance of distal cutting edge of surgical specimen was shorter than that of LaTME group(P<0.05).There were no statistical significance in the number of lymph node detection,lymph node positive,CRM positive rate,pathological stage(P>0.05).The median follow-up time was 10.5 months.Two patients with positive peritoneal lavage had local recurrence,one in TaTME group and one in LaTME group,and no recurrence was found in patients with negative peritoneal lavage.Conclusions The positive rate of tumor cytology in TaTME and LaTME was similar,and there was no significant difference in the local recurrence rate during short-term follow-up;the positive rate of postoperative lavage was positively correlated with tumor stage;the positive rate of tumor cytology in peritoneal lavage suggested that the risk of local recurrence might be increased.