Proctectomy for Rectal Cancer
5 results
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Malignancy- A 25-year-old obese female patient with a known diagnosis of familial adenomatosis polyposis is preparing for prophylactic surgery. Colonoscopy reveals more than 200 small polyps in her colon with no significant polyps distal to the sigmoid. She desires to have children as soon as possible. Which surgical option will minimize her cancer risk while giving her the best chance of preserving fertility?
- A 56-year-old man presents to the office with biopsy-proven midrectal adenocarcinoma on colonoscopy. Rigid sigmoidoscopy in the office shows a 5-cm circumferential mass 8 cm from the anal verge. Staging evaluation with computed tomography of the chest, abdomen, and pelvis and magnetic resonance imaging of the pelvis preoperatively demonstrates a T3N1M0 cancer. What is the next step in management for this patient?
- A 64-year-old man with a midrectal cancer undergoes neoadjuvant therapy and subsequent total mesorectal excision with anastomosis. After surgery, he complains of urge urinary incontinence and retrograde ejaculation. Which of the following aspects of the operative procedure are responsible for his postoperative symptoms?
- 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?