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Sphincter-preserving surgery for recurrent pelvic malignancy using a hybrid procedure of open laparotomy and transanal endoscopic approach
BACKGROUND: Surgery for the treatment of recurrent pelvic malignancy is challenging. Sphincter-preserving surgery (SPS) has been applied in limited cases. Transanal endoscopic approach (TEA) has been used for primary rectal cancer, predominantly for hybrid transabdominal-transanal total mesorectal e...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Berlin Heidelberg
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5897265/ https://www.ncbi.nlm.nih.gov/pubmed/29651788 http://dx.doi.org/10.1186/s40792-018-0439-y |
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author | Ishiguro, Seiji Komatsu, Shunichiro Komaya, Kenichi Saito, Takuya Arikawa, Takashi Kaneko, Kenichiro Sano, Tsuyoshi |
author_facet | Ishiguro, Seiji Komatsu, Shunichiro Komaya, Kenichi Saito, Takuya Arikawa, Takashi Kaneko, Kenichiro Sano, Tsuyoshi |
author_sort | Ishiguro, Seiji |
collection | PubMed |
description | BACKGROUND: Surgery for the treatment of recurrent pelvic malignancy is challenging. Sphincter-preserving surgery (SPS) has been applied in limited cases. Transanal endoscopic approach (TEA) has been used for primary rectal cancer, predominantly for hybrid transabdominal-transanal total mesorectal excision. Here, we describe the use of TEA as a hybrid approach in a case of recurrent ovarian cancer. CASE PRESENTATION: A 59-year-old woman had recurrence of serous ovarian adenocarcinoma in the vaginal stump, near the site of anastomosis from a rectal resection 18 months previously. We used a hybrid approach comprising conventional open laparotomy and TEA to accomplish sphincter preservation. In addition to sphincter preservation, TEA allowed for the creation of a “terminal” space, which was made by anterior dissection between the rectum and the vagina. We employed TEA to create an opening in the scar tissue along the sacrum, which was used as a “guide” for pelvic dissection to prevent nerve injury. After exteriorization of the tumor, bowel continuity was achieved by hand-sewn coloanal anastomosis with a protective diverting ileostomy. Pathological examination revealed no involvement of the surgical margins. The diverting ileostomy was taken down 8 months postoperatively. CONCLUSION: A hybrid approach comprising conventional open laparotomy and TEA allowed for safe and secure SPS and complete excision of a recurrent pelvic malignancy. This hybrid surgical approach expands the use of SPS in highly selected cases. |
format | Online Article Text |
id | pubmed-5897265 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Springer Berlin Heidelberg |
record_format | MEDLINE/PubMed |
spelling | pubmed-58972652018-04-17 Sphincter-preserving surgery for recurrent pelvic malignancy using a hybrid procedure of open laparotomy and transanal endoscopic approach Ishiguro, Seiji Komatsu, Shunichiro Komaya, Kenichi Saito, Takuya Arikawa, Takashi Kaneko, Kenichiro Sano, Tsuyoshi Surg Case Rep Case Report BACKGROUND: Surgery for the treatment of recurrent pelvic malignancy is challenging. Sphincter-preserving surgery (SPS) has been applied in limited cases. Transanal endoscopic approach (TEA) has been used for primary rectal cancer, predominantly for hybrid transabdominal-transanal total mesorectal excision. Here, we describe the use of TEA as a hybrid approach in a case of recurrent ovarian cancer. CASE PRESENTATION: A 59-year-old woman had recurrence of serous ovarian adenocarcinoma in the vaginal stump, near the site of anastomosis from a rectal resection 18 months previously. We used a hybrid approach comprising conventional open laparotomy and TEA to accomplish sphincter preservation. In addition to sphincter preservation, TEA allowed for the creation of a “terminal” space, which was made by anterior dissection between the rectum and the vagina. We employed TEA to create an opening in the scar tissue along the sacrum, which was used as a “guide” for pelvic dissection to prevent nerve injury. After exteriorization of the tumor, bowel continuity was achieved by hand-sewn coloanal anastomosis with a protective diverting ileostomy. Pathological examination revealed no involvement of the surgical margins. The diverting ileostomy was taken down 8 months postoperatively. CONCLUSION: A hybrid approach comprising conventional open laparotomy and TEA allowed for safe and secure SPS and complete excision of a recurrent pelvic malignancy. This hybrid surgical approach expands the use of SPS in highly selected cases. Springer Berlin Heidelberg 2018-04-12 /pmc/articles/PMC5897265/ /pubmed/29651788 http://dx.doi.org/10.1186/s40792-018-0439-y Text en © The Author(s). 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. |
spellingShingle | Case Report Ishiguro, Seiji Komatsu, Shunichiro Komaya, Kenichi Saito, Takuya Arikawa, Takashi Kaneko, Kenichiro Sano, Tsuyoshi Sphincter-preserving surgery for recurrent pelvic malignancy using a hybrid procedure of open laparotomy and transanal endoscopic approach |
title | Sphincter-preserving surgery for recurrent pelvic malignancy using a hybrid procedure of open laparotomy and transanal endoscopic approach |
title_full | Sphincter-preserving surgery for recurrent pelvic malignancy using a hybrid procedure of open laparotomy and transanal endoscopic approach |
title_fullStr | Sphincter-preserving surgery for recurrent pelvic malignancy using a hybrid procedure of open laparotomy and transanal endoscopic approach |
title_full_unstemmed | Sphincter-preserving surgery for recurrent pelvic malignancy using a hybrid procedure of open laparotomy and transanal endoscopic approach |
title_short | Sphincter-preserving surgery for recurrent pelvic malignancy using a hybrid procedure of open laparotomy and transanal endoscopic approach |
title_sort | sphincter-preserving surgery for recurrent pelvic malignancy using a hybrid procedure of open laparotomy and transanal endoscopic approach |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5897265/ https://www.ncbi.nlm.nih.gov/pubmed/29651788 http://dx.doi.org/10.1186/s40792-018-0439-y |
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