ABDOMINOPERINEAL RESECTION OF THE RECTUM FOR LYMPHOGRANULOMA*
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Abdominoperineal resection
Lymphogranuloma venereum
The technique of laparoscopic sigma-/rectum-resection and the technique of the laparoscopic abdominoperineal excision of the rectum are discussed under oncological aspects. The results of 24 laparoscopic resections of sigma and rectum and of 15 laparoscopic abdominoperineal excisions of the rectum are demonstrated.
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Abdominoperineal resection
Infiltration (HVAC)
Contraindication
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BACKGROUND: Synchronous neoplasms of the rectum are an uncommon condition. The situation becomes more rare when tumors are of different origin. To the authors' knowledge, synchronous anorectal melanoma and adenocarcinoma of the rectum have not been reported in the literature before. METHODS AND RESULTS: A 67-year-old female patient with synchronous anorectal malignant melanoma and adenocarcinoma of the rectum is described. She had preoperative colonoscopic diagnosis. The different neoplasms' origin was histologically proven. Surgical management consisted of abdominoperineal resection of the rectum. Postoperatively, the patient received adjuvant chemotherapy of six cycles duration. At present, the patient has completed 32 months of follow-up. There is no evidence of recurrent disease or distant metastases. CONCLUSION: Review of the literature confirms the rarity of anorectal malignant melanoma. On the other hand, the rectum represents the most common site for development of colonic adenocarcinoma. We were unable to trace synchronous presentation of these two tumors. Prognosis should be defined by the most malignant neoplasm; therefore, management should be focused on treating the melanoma.
Surgical oncology
Colorectal Surgery
Rectal diseases
Anus neoplasms
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Summary A closed system of drainage of perineal wounds and the bladder after abdominoperineal resection of the rectum has been described. It has lessened the incidence of wound and bladder infections. It shortens the period of hospitalization and lessens the discomfort of the patient. It makes possible early mobility of the patient while in bed and early ambulation. It also facilitates nursing care of patients who undergo abdominoperineal resection of the rectum.
Abdominoperineal resection
Colorectal Surgery
Surgical oncology
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THE FOLLOWING review regarding the urological complications after abdominoperineal resection of the rectum or rectosigmoid is based on a review of 105 patients operated on. The authors have attempted to formulate a set of conclusions from this review which they hope may serve as an aid in preventing the urological complications most frequently associated with this operation. All resections of the rectum were done for carcinoma, except in two patients. One operation was performed on a paraplegic for severe ulcerative colitis and the other for an extensive benign polyposis of the rectum. Two series of patients were studied. The first group was evaluated on the basis of a two-year postoperative follow-up examination. The second group was followed through completely from the preoperative and postoperative examinations over a one and one-half year postoperative period. In the first series, 49 patients came to surgery in the two-year period of 1947 and 1948.
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We describe two cases of lymphogranuloma venereum (LGV) in men who have sex with men in Portugal in 2008. These first two confirmed cases of LGV L2b proctitis in Portugal highlight the need for an enhanced surveillance programme in Portugal.
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Primary malignant melanoma of the rectum is a very aggressive tumor with a 5-year survival rate of 6%. Most reports include cases of both anal and of rectal melanoma together. We report 2 women with primary melanoma of the rectum, aged 67 and 72 years, who underwent abdominoperineal resection and survived 5 and 7 months respectively.
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Abdominoperineal resection
Debridement (dental)
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Primary anorectal melanoma is rare. There is controversy regarding the best surgical treatment because of its poor prognosis. Three cases with extended follow-up are reported in this article. A 53-year-old woman with rectal bleeding was diagnosed with a melanoma of the rectum and underwent an abdominoperineal resection. The patient died with distant metastases 8 months later. An 80-year-old woman with rectal bleeding was diagnosed with a melanoma of the rectum and underwent a transanal local excision. She remains alive 4 years later but with locally recurrent disease. A 78-year-old man with rectal bleeding was diagnosed with a melanoma of the rectum and underwent an abdominoperineal resection. He died with local and metastatic disease 25 months later. Recent trends favor local excision when technically feasible, although some patients may require an abdominoperineal resection of the rectum, especially for larger tumors.
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