Abdominoperineal Resection
9 results
1 - 9
Benign Disease- A 34-year-old otherwise healthy woman, who underwent total abdominal colectomy with end ileostomy 1 year ago for fulminant Crohn’s disease colitis, presents to the office with ongoing bloody mucoid discharge per rectum and tenesmus. On examination, her abdomen is unremarkable with end ileostomy. Ileostomy is healthy and pouches well. Rectal examination is remarkable for normal perineal skin, normal tone, and absence of fistula and fissure. She has been through four different biologics. Endoscopy shows deep ulcers in the rectum with mucosal friability. She has bothersome mucoid anal discharge multiple times per day and wishes to know whether this can be resolved. Her small bowel disease was previously active and is now quiescent on entyvio. What is the best next option in her management?
- Five years after abdominoperineal resection (APR) for rectal cancer, a 57-year-old woman presents with bulging at the site of a left lower quadrant colostomy. She is concerned regarding her physical appearance and symptoms of rare fecal leakage at the appliance. The best initial treatment for this patient is
- Miscellaneous
- Malignancy
- A 67-year-old man with anal cancer involving anterior rectal wall and dentate line and prostate, staged T4N1aM0, had undergone chemoradiation and presents for evaluation 8 weeks after therapy completion. He reports that discomfort is nearly gone from the anal canal and that his bowel movements are normal. On examination, there is a shallow 1-cm ulcer. What is the best next option?
- A 56-year-old obese man with locally advanced distal rectal cancer is treated with total neoadjuvant chemoradiation therapy. His is a 45-pack-per-year smoker. Restaging reveals no sign of metastasis. Magnetic resonance imaging (MRI) rectal protocol reveals partial clinical response and flexible sigmoidsociopy that shows a 3-cm tumor involving the sphincteric complex. What is the best surgical approach in his care?
- A 47-year-old woman presents with rectal pain and feculent discharge from her vagina. A digital rectal exam (DRE) in the office reveals a 4-cm, firm, palpable mass starting just below the dentate line; it is immobile and contiguous with the posterior vaginal wall. You perform a biopsy that confirms squamous cell carcinoma. After completing the staging workup, you find she has T4N0, stage IIIB disease. The recommended treatment is
- A 57-year-old man undergoes total neoadjuvant therapy (TNT) for management of a cT3N1M0 rectal cancer. After completion of both chemotherapy/radiotherapy and consolidation chemotherapy, the presence of complete clinical response to treatment is assessed by
- During screening colonoscopy, a 0.9-cm rectal polyp was removed using a saline lift snare polypectomy. Pathology was significant for well-differentiated submucosal neuroendocrine tumor without lymphovascular involvement or penetration into the muscularis propria. What is the best next step in management?
- Anorectal Disease