Transanal Total Mesorectal Excision (Ta-TME) in a Rectal Cancer Patient with a History of Abdominal Surgery: A Case Report
A 65-year-old man was followed up after undergoing Hartmann's operation for the treatment of obstructive colon cancer 1 year earlier. He presented with bloody stool and underwent examination, including lower gastrointestinal endoscopy, and he was diagnosed with rectal cancer. Since he had a his...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
The Japan Society of Coloproctology
2020-01-01
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| Series: | Journal of the Anus, Rectum and Colon |
| Subjects: | |
| Online Access: | https://www.jstage.jst.go.jp/article/jarc/4/1/4_2019-028/_pdf/-char/en |
| _version_ | 1828841795172171776 |
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| author | Satoshi Narihiro Hironori Ohdaira Hideyuki Takeuchi Teppei Kamada Rui Marukuchi Norihiko Suzuki Sojun Hoshimoto Masashi Yoshida Yutaka Suzuki |
| author_facet | Satoshi Narihiro Hironori Ohdaira Hideyuki Takeuchi Teppei Kamada Rui Marukuchi Norihiko Suzuki Sojun Hoshimoto Masashi Yoshida Yutaka Suzuki |
| author_sort | Satoshi Narihiro |
| collection | DOAJ |
| description | A 65-year-old man was followed up after undergoing Hartmann's operation for the treatment of obstructive colon cancer 1 year earlier. He presented with bloody stool and underwent examination, including lower gastrointestinal endoscopy, and he was diagnosed with rectal cancer. Since he had a history of multiple abdominal surgeries, including Hartmann's operation, severe pelvic adhesions were expected. Thus, in consideration of surgical safety and curability, transanal total mesorectal excision (Ta-TME) was performed. The duration of the surgery was 3 h, and there was minimal blood loss. Histopathological findings did not reveal remnants of cancer in the resected margin, and the patient was discharged on hospital day 7. Rectal cancer has a higher rate of local recurrence than colon cancer. To prevent local recurrence, ensuring a rectal circumferential resection margin (CRM) with TME is essential, which is, however, challenging in obese patients and in those with giant tumors, contracted pelvis, prostatic hypertrophy, etc., since these conditions complicate pelvic surgery. The same is true for patients with a history of multiple abdominal surgeries. It is expected that these problems can be resolved by Ta-TME. In the present case, Ta-TME was extremely useful in rectal cancer surgery for a patient with a history of multiple abdominal surgeries, including Hartmann's operation. |
| first_indexed | 2024-12-12T20:10:42Z |
| format | Article |
| id | doaj.art-94c5328128aa4e9bad761e58e9e555c3 |
| institution | Directory Open Access Journal |
| issn | 2432-3853 |
| language | English |
| last_indexed | 2024-12-12T20:10:42Z |
| publishDate | 2020-01-01 |
| publisher | The Japan Society of Coloproctology |
| record_format | Article |
| series | Journal of the Anus, Rectum and Colon |
| spelling | doaj.art-94c5328128aa4e9bad761e58e9e555c32022-12-22T00:13:31ZengThe Japan Society of ColoproctologyJournal of the Anus, Rectum and Colon2432-38532020-01-0141414610.23922/jarc.2019-0282019-028Transanal Total Mesorectal Excision (Ta-TME) in a Rectal Cancer Patient with a History of Abdominal Surgery: A Case ReportSatoshi Narihiro0Hironori Ohdaira1Hideyuki Takeuchi2Teppei Kamada3Rui Marukuchi4Norihiko Suzuki5Sojun Hoshimoto6Masashi Yoshida7Yutaka Suzuki8Department of Surgery, International University of Health and Welfare HospitalDepartment of Surgery, International University of Health and Welfare HospitalDepartment of Surgery, International University of Health and Welfare HospitalDepartment of Surgery, International University of Health and Welfare HospitalDepartment of Surgery, International University of Health and Welfare HospitalDepartment of Surgery, International University of Health and Welfare HospitalDepartment of Surgery, International University of Health and Welfare HospitalDepartment of Surgery, International University of Health and Welfare HospitalDepartment of Surgery, International University of Health and Welfare HospitalA 65-year-old man was followed up after undergoing Hartmann's operation for the treatment of obstructive colon cancer 1 year earlier. He presented with bloody stool and underwent examination, including lower gastrointestinal endoscopy, and he was diagnosed with rectal cancer. Since he had a history of multiple abdominal surgeries, including Hartmann's operation, severe pelvic adhesions were expected. Thus, in consideration of surgical safety and curability, transanal total mesorectal excision (Ta-TME) was performed. The duration of the surgery was 3 h, and there was minimal blood loss. Histopathological findings did not reveal remnants of cancer in the resected margin, and the patient was discharged on hospital day 7. Rectal cancer has a higher rate of local recurrence than colon cancer. To prevent local recurrence, ensuring a rectal circumferential resection margin (CRM) with TME is essential, which is, however, challenging in obese patients and in those with giant tumors, contracted pelvis, prostatic hypertrophy, etc., since these conditions complicate pelvic surgery. The same is true for patients with a history of multiple abdominal surgeries. It is expected that these problems can be resolved by Ta-TME. In the present case, Ta-TME was extremely useful in rectal cancer surgery for a patient with a history of multiple abdominal surgeries, including Hartmann's operation.https://www.jstage.jst.go.jp/article/jarc/4/1/4_2019-028/_pdf/-char/entransanal total mesorectal excisionhartmann's operation, rectal cancer |
| spellingShingle | Satoshi Narihiro Hironori Ohdaira Hideyuki Takeuchi Teppei Kamada Rui Marukuchi Norihiko Suzuki Sojun Hoshimoto Masashi Yoshida Yutaka Suzuki Transanal Total Mesorectal Excision (Ta-TME) in a Rectal Cancer Patient with a History of Abdominal Surgery: A Case Report Journal of the Anus, Rectum and Colon transanal total mesorectal excision hartmann's operation, rectal cancer |
| title | Transanal Total Mesorectal Excision (Ta-TME) in a Rectal Cancer Patient with a History of Abdominal Surgery: A Case Report |
| title_full | Transanal Total Mesorectal Excision (Ta-TME) in a Rectal Cancer Patient with a History of Abdominal Surgery: A Case Report |
| title_fullStr | Transanal Total Mesorectal Excision (Ta-TME) in a Rectal Cancer Patient with a History of Abdominal Surgery: A Case Report |
| title_full_unstemmed | Transanal Total Mesorectal Excision (Ta-TME) in a Rectal Cancer Patient with a History of Abdominal Surgery: A Case Report |
| title_short | Transanal Total Mesorectal Excision (Ta-TME) in a Rectal Cancer Patient with a History of Abdominal Surgery: A Case Report |
| title_sort | transanal total mesorectal excision ta tme in a rectal cancer patient with a history of abdominal surgery a case report |
| topic | transanal total mesorectal excision hartmann's operation, rectal cancer |
| url | https://www.jstage.jst.go.jp/article/jarc/4/1/4_2019-028/_pdf/-char/en |
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