TWO CASES OF RECTAL CANCER ACCOMPANIED WITH RADIATION COLITIS
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This paper presents two cases of rectal cancer accompanied with radiation colitis. Case 1 was a 53-year-old woman, who had a history of underdoing radiation therapy for a uterine cervical cancer 11 years before. She was seen at the hospital because of constipation and pointed out a IIa like lesion on the rectum by colonoscopy. Abdominoperineal resection was performed. The surgical specimen showed the IIa like lesion on the rectum. Pathological findings revealed well differentiated adenocarcinoma. Immunohistochemical staining of p53 showed positive cells in atrophic glands. Case 2 was a 62-year-old woman complaining of diarrhea. There was a previous history of receiving radiation therapy for a uterine cancer 20 years before. Colonoscopy showed a Borrmann type 2 cancer on the rectum. Abdominoperineal resection was performeed. Histological findings revealed moderately differentiated adenocarcinoma invading to the propria muscle. The features of radiation colitis were observed around the cancer int he two cases which provided a clue to diagnose the lesions with radiation induced cancer.Keywords:
Abdominoperineal resection
Abdominoperineal resection
Infiltration (HVAC)
Contraindication
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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.
Abdominoperineal resection
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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.
Abdominoperineal resection
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Objective To summarize the technique of one-man colonoscopy. Method The data of one-man colonoscopy and two-men colonoscopy on 360 patients were comparatively analyzed. Results The success rate of one-man colonoscopy was up to 96.9%, while two-men colonoscopy was 85.5%. The rate of reaching the end of ileum by one-man colonoscopy was 85%, and that of two-men colonoscopy was 56.0%. Eight minutes and eight seconds were spent for one-man colonoscopy to reach ileocecus on average, which was faster than two-men colonoscopy(11.5 minutes on average). The incidence of complication caused by two-men colonoscopy was 0%, whereas two-men colonoscopy was 0.88%. All results of one-man colonoscopy were superior to those of the control group. Conclusion One-man colonoscopy is not only time-saving and manpower-saving, but also safe and efficient.
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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.
Abdominoperineal resection
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Abdominoperineal resection
Debridement (dental)
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As the significance of the quantitative fecal immunochemical test (FIT) in patients who previously underwent a colonoscopy is unknown, this study aimed at investigating the association between fecal hemoglobin concentration and the risk of colorectal cancer (CRC).We retrospectively analyzed FIT-positive patients who underwent a colonoscopy through our opportunistic annual screening program from April 2010 to March 2017 at the Kyoto Second Red Cross Hospital. We stratified them into no colonoscopy and past colonoscopy (>5 years or ≤5 years) groups based on whether they had a history of undergoing a colonoscopy and analyzed the correlation between fecal hemoglobin concentration and advanced neoplasia or invasive cancer detection in each group. We analyzed 1248 patients with positive FIT results. There were 748 (59.9%), 198 (15.9%), and 302 (24.2%) patients in the no colonoscopy, past colonoscopy (>5 years), and past colonoscopy (≤5 years) groups, respectively. In the no colonoscopy group, the advanced neoplasia detection rate significantly increased with the fecal hemoglobin concentration (P < 0.001). However, no significant trend was observed in the past colonoscopy (both >5 years and ≤5 years) group (P = 0.982). No invasive cancer was detected in the past colonoscopy (≤5 years) group.The risk of CRC might be low even if fecal hemoglobin concentration was high, especially in those who underwent colonoscopy within 5 years.
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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.
Abdominoperineal resection
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