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TAMIS for Recurrent Cancer of the High Rectum (25 cm from the Anal Verge) in a Patient with Serious Associated Disorders (Rescue Surgery) | ||
| Iranian Journal of Colorectal Research | ||
| مقاله 8، دوره 9، شماره 2، شهریور 2021، صفحه 82-85 اصل مقاله (908.82 K) | ||
| نوع مقاله: Case Report | ||
| شناسه دیجیتال (DOI): 10.30476/acrr.2021.91751.1106 | ||
| نویسندگان | ||
| Alessandro Verbo1؛ Vito Laterza1؛ Marco Montagna* 2؛ Giovanni Di Palma3؛ Giovanni Moschetta1؛ Annamaria Martullo1 | ||
| 1Catholic University of the Sacred Hearth, Policlinico Agostino Gemelli IRCCS Rome, Italy | ||
| 2Catholic University of the Sacred Hearth, Policlinico Agostino Gemelli IRCCS Rome, Italy Ospedali Riuniti, Foggia, Italy | ||
| 3General Regional Hospital F. Miulli Acquaviva delle Fonti Italy | ||
| چکیده | ||
| INTRODUCTION Transanal Minimally invasive surgery (TAMIS) is indicated for benign lesions of the rectum distant up to 5 cm and not exceeding more than 1/3 of the rectal circumference; for early stage malignancies confined to the submucosa (T1 sm1 according to the Kikuchi classification); for cancers after complete response to neoadiuvant treatments or with T1 residue (due to a risk of mesorectal positive lymph node between 3-6%); for T2-T3 N0 in patients who cannot undergo major surgical resections due to a compromised general (rescue surgery). TAMIS is especially recommended for neoplasms located at a distance between 5 and 18 cm from the anal verge. CASE PRESENTATION We performed TAMIS on a 72-year-old patient diagnosed with diffuse polyposis syndrome (FAP), with multimorbidity and a history of recurrences, all treated with surgical resection, AND with a new recurrence on the ileo-rectal anastomosis at about 25 cm from the anal verge. A rectoscopy and a total body CT were performed (anastomotic level; size 2 cm; staging: cT1-2, N0, M0; histology: adenocarcinoma). The final decision after multidisciplinary meeting was for TAMIS, due to high intra- and post-operative risk contraindicating major surgery. Data regarding total operating time, blood losses, length of stay, surgical and general intra and post-operative complications, resumption of nutrition and therapies (antibiotics and pain relievers) were collected. The operation was successful, with a total operating time of 55 minutes, and an estimated blood loss of 20 ml. The patient was rapidly mobilized and nutrition promptly resumed. The length of stay was 3 days. We did not observe any complications. CONCLUSION We showed for this patient the feasibility and safety of TAMIS resections at greater distances than those normally recommended. | ||
| کلیدواژه‌ها | ||
| Transanal Minimally invasive surgery (TAMIS)؛ rectal cancer؛ laparoscopic surgery | ||
| مراجع | ||
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