Abdominoperineal Resection
11 results
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Benign Disease- A 65-year-old man with a history of rectal cancer underwent abdominoperineal resection 10 years ago. He presents with a large, symptomatic parastomal hernia. Which technique has the lowest recurrence rate?
- A 65-year-old woman with coronary artery disease and a history of abdominoperineal resection for a low rectal cancer 3 years ago presents with a painless peristomal bulge and an occasional appliance leak. She denies pain and reports normal colostomy output. Examination reveals a pink healthy colostomy and soft bulge medial to the stoma on application of the Valsalva maneuver. Result of recent surveillance computed tomography is available for review (Figure). What is the best management option?
- A 70-year-old man with history of perianal Crohn’s disease and 15-year history of an anal fistula presents to establish care. On examination, he has a right anterior anal fistula that appears chronic in nature. What is the best next step in management?
- Miscellaneous
- Malignancy
- A 64-year-old woman with a history of cervical intraepithelial neoplasia presents with a firm 3-cm mass protruding at the anal verge. Anoscopy shows a fixed mass just distal to the dentate line. A biopsy of the lesion is performed, which has the findings shown in the Figure. Colonoscopy findings are unremarkable and computed tomography of the chest, abdomen, and pelvis reveals no evidence of distant disease. Magnetic resonance imaging reveals no locoregional nodal or sphincter involvement. The next best step in management for this patient is:
- A 63-year-old woman is diagnosed with a 1.5-cm, well-differentiated perianal squamous cell cancer that is 3.5 cm from the anal verge, with no involvement of the anal sphincter mechanism. There is no radiographic evidence of inguinal nodal or metastatic disease. The best treatment option for this patient is:
- A 50-year-old woman is found to have a 7-mm submucosal yellow lesion in the distal rectum on screening colonoscopy. There is no pillow sign. What is the most likely diagnosis?
- A 65-year-old man was diagnosed with a 1.5-cm lesion at the anal verge. Biopsies were positive for S100 and HMB-45. Computed tomography of the chest, abdomen, and pelvis showed no metastases. Which is the next best step in this patient’s treatment?
- A 53-year-old man is diagnosed with rectal adenocarcinoma 7 cm from the anal verge. Preoperative pelvic magnetic resonance imaging (MRI) demonstrates a threatened circumferential radial margin. After total neoadjuvant chemoradiation, a repeat MRI demonstrates a persistently threatened radial margin. Which of the following adjuncts should be considered in operative planning for this patient?
- A 68-year-old man with a history of a hemorrhoidectomy and fecal urgency presents with a T3n1m0 rectal cancer 5 cm from the anal verge. He has no family history of colorectal cancer. What is the most important consideration when counseling the patient about his surgical treatment options?
- Perioperative