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Transperineal total mesorectal excision for rectal cancer on the residual rectum after multiple abdominal surgeries in a patient with Crohn's disease: a case report

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Title: Transperineal total mesorectal excision for rectal cancer on the residual rectum after multiple abdominal surgeries in a patient with Crohn's disease: a case report
Authors: Emoto, Shin Browse this author
Homma, Shigenori Browse this author
Yoshida, Tadashi Browse this author
Ichikawa, Nobuki Browse this author
Miyaoka, Yoichi Browse this author
Matsui, Hiroki Browse this author
Takahashi, Ryo Browse this author
Ishido, Keita Browse this author
Otsuka, Takuya Browse this author
Mitsuhashi, Tomoko Browse this author
Katsurada, Takehiko Browse this author
Taketomi, Akinobu Browse this author
Keywords: Rectal cancer
Crohn's disease
History of surgery
Laparoscopic surgery
Transperineal total mesorectal excision
Issue Date: 13-May-2021
Publisher: Springer
Journal Title: Surgical case reports
Volume: 7
Issue: 1
Start Page: 122
Publisher DOI: 10.1186/s40792-021-01206-7
Abstract: Background: The improved prognosis of Crohn's disease may increase the opportunities of surgical treatment for patients with Crohn's disease and the risk of development of colorectal cancer. We herein describe a patient with Crohn's disease and a history of multiple surgeries who developed rectal stump carcinoma that was treated laparoscopically and transperineally. Case presentation: A 51-year-old man had been diagnosed with Crohn's disease 35 years earlier and had undergone several operations for treatment of Crohn's colitis. Colonoscopic examination was performed and revealed rectal cancer at the residual rectum. The patient was then referred to our department. The tumor was diagnosed as clinical T2N0M0, Stage I. We treated the tumor by combination of laparoscopic surgery and concomitant transperineal resection of the rectum. While the intra-abdominal adhesion was dissected laparoscopically, rectal dissection in the correct plane progressed by the transperineal approach. The rectal cancer was resected without involvement of the resection margin. The duration of the operation was 3 h 48 min, the blood loss volume was 50 mL, and no intraoperative complications occurred. The pathological diagnosis of the tumor was type 5 well- and moderately differentiated adenocarcinoma, pT2N0, Stage I. No recurrence was evident 3 months after the operation, and no adjuvant chemotherapy was performed. Conclusion: The transperineal approach might be useful in patients with Crohn's disease who develop rectal cancer after multiple abdominal surgeries.
Type: article
Appears in Collections:北海道大学病院 (Hokkaido University Hospital) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

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