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Case Reports
. 2018 Feb 6;12(1):28.
doi: 10.1186/s13256-017-1555-1.

Laparoscopic low anterior resection for rectal cancer with rectal prolapse: a case report

Ryusei Yamamoto  1 , Yasuji Mokuno  2 , Hideo Matsubara  2 , Hirokazu Kaneko  2 , Shinsuke Iyomasa  2
Affiliations
Case Reports

Laparoscopic low anterior resection for rectal cancer with rectal prolapse: a case report

Ryusei Yamamoto et al. J Med Case Rep. .

Abstract

Background: Rectal cancer with rectal prolapse is rare, described by only a few case reports. Recently, laparoscopic surgery has become standard procedure for either rectal cancer or rectal prolapse. However, the use of laparoscopic low anterior resection for rectal cancer with rectal prolapse has not been reported.

Case presentation: A 63-year-old Japanese woman suffered from rectal prolapse, with a mass and rectal bleeding for 2 years. An examination revealed complete rectal prolapse and the presence of a soft tumor, 7 cm in diameter; the distance from the anal verge to the tumor was 5 cm. Colonoscopy demonstrated a large villous tumor in the lower rectum, which was diagnosed as adenocarcinoma on biopsy. We performed laparoscopic low anterior resection using the prolapsing technique without rectopexy. The distal surgical margin was more than 1.5 cm from the tumor. There were no major perioperative complications. Twelve months after surgery, our patient is doing well with no evidence of recurrence of either the rectal prolapse or the cancer, and she has not suffered from either fecal incontinence or constipation.

Conclusions: Laparoscopic low anterior resection without rectopexy can be an appropriate surgical procedure for rectal cancer with rectal prolapse. The prolapsing technique is useful in selected patients.

Keywords: Laparoscopic; Low anterior resection; Prolapsing technique; Rectal cancer; Rectal prolapse.

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Conflict of interest statement

Ethics approval and consent to participate

The institutional ethics committee approved the publication of this case report.

Consent for publication

Written informed consent was obtained from the patient for publication of this case report and any accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal.

Competing interests

The authors declare that they have no competing interests.

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Figures

Fig. 1
Fig. 1
Physical examination showing complete rectal prolapse of the entire thickness of the rectum with a soft, 7-cm tumor with ulceration. a: frontal view, b: lateral view
Fig. 2
Fig. 2
Computed tomography scan showing the lower rectum filled with a tumor measuring 7 × 6 cm, enhanced with contrast medium. The arrows pointing to the tumor. a axial plane, b sagittal plane
Fig. 3
Fig. 3
Gastrografin enema showing a tumor located in the posterior wall of the lower rectum. The arrows pointing to the tumor. a coronal plane, b sagittal plane
Fig. 4
Fig. 4
Colonoscopy showing a large villous tumor in the lower rectum
Fig. 5
Fig. 5
Laparoscopic view showing mobilization of the rectum using the total mesorectal excision technique; the dissection is extended distally to expose the entire circumference of the levator ani muscle. i vagina; ii rectum; iii levator ani muscle
Fig. 6
Fig. 6
a The distal rectum is everted and pulled outside of the anus. i tumor; ii anus; R everted rectum. b The distal rectum is transected under direct visualization. c Laparoscopic view showing the stump of the rectum reduced into the pelvis after resection
Fig. 7
Fig. 7
a Gross examination showing an ulcerated, cauliflower-shaped, soft tumor, measuring 7 × 8 × 3 cm, located in the lower rectum; the proximal colon is also resected. b The distal margin of the rectum is more than 1.5 cm from the tumor. c Histologic examination showing a moderately differentiated tubular adenocarcinoma, almost entirely intramucosal, with focal invasion of the submucosal layer
See this image and copyright information in PMC

References

    1. Kairaluoma MV, Kellokumpu IH. Epidemiologic aspects of complete rectal prolapse. Scand J Surg. 2005;94:207–10. doi: 10.1177/145749690509400306. - DOI - PubMed
    1. Felt-Bersma RJ, Tiersma ES, Cuesta MA. Rectal prolapse, rectal intussusception, rectocele, solitary rectal ulcer syndrome, and enterocele. Gastroenterol Clin North Am. 2008;37:645–68. doi: 10.1016/j.gtc.2008.06.001. - DOI - PubMed
    1. Henry LG, Cattey RP. Rectal prolapse. Surg Laparosc Endosc. 1994;4:357–60. doi: 10.1097/00019509-199410000-00007. - DOI - PubMed
    1. Purkayastha S, Tekkis P, Athanasiou T, Aziz O, Paraskevas P, Ziprin P, et al. A comparison of open vs. laparoscopic abdominal rectopexy for full-thickness rectal prolapse: a meta-analysis. Dis Colon Rectum. 2005;48:1930–40. doi: 10.1007/s10350-005-0077-x. - DOI - PubMed
    1. van der Pas MH, Haglind E, Cuesta MA, Fürst A, Lacy AM, Hop WC, Colorectal cancer Laparoscopic or Open Resection II (COLOR II) Study Group et al. Laparoscopic versus open surgery for rectal cancer (COLOR II): short-term outcomes of a randomised, phase 3 trial. Lancet Oncol. 2013;14:210–8. doi: 10.1016/S1470-2045(13)70016-0. - DOI - PubMed

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