The aetiology of colonic suture-line recurrence

Cell viability studies have been performed on human desquamated colonic cancer cells obtained by both in-vivo and ex-vivo techniques, and on desquamated colonic cancer cells from an experimental animal model. There was no evidence of cell viability and I conclude that the hypothesis that suture-line recurrence occurs as a result of the implantation of desquamated tumour cells is of questionable validity. Field change in the colonic mucosa has been studied by examining the reactions of the mucosubstances in the goblet cells. A potential correlation between transitional mucosa at the anastomosis and the development of suture-line recurrence was found and warrants further study. The clinical problem has been investigated by the clinicopathological study of 16 patients developing suture-line recurrence in an attempt to discern the aetiology of each. In all but one the recurrence was due to incomplete excision of cancer or, in one instance, a second primary growth.