Free Malignant Cells in Relation to Recurrence of Carcinoma of the Colon

Follow-up observations on patients operated on for carcinoma of the colon at the Illinois Research Hospital during the past several years have revealed an alarmingly high incidence of local recurrence of carcinoma at the suture line after resection and primary end-to-end anastomosis. This led one of us (W. H. C.)1to suspect implantation of cancer cells by the suturing procedure at the time of operation. This same fear has been expressed by Goligher and associates,2who reported a 10% local recurrence of carcinoma in 162 patients having local resection of the proximal part of the rectum followed by end-to-end anastomosis or colostomy and inversion of the rectal stump (Hartmann operation). In two of their patients carcinoma became imbedded in the soft tissues of the abdominal wall or perineum. These authors studied an additional 7 cases (total of 23) of local recurrence of carcinoma obtained from other hospitals. In