Ultralow laparoscopic anterior resection and anastomosis in adenocarcinoma of the rectum: report of a case

Abstract

Introduction: Colorectal cancer is the second cause of death in the western world, currently the minimally invasive laparoscopic approach has shown benefits over conventional open surgery. Clinical case: The case of a 53-year-old woman who presented proctorrhea of 6 months of evolution accompanied by mucorrhea and difficulty in bowel movements is reported. The colonoscopy identified a lesion 7 cm from the anal edge that occludes 2/3 of the intestinal lumen. The biopsy reported rectal adenocarcinoma. Exploratory laparoscopy and ultra-low anterior resection with end-to-end anastomosis plus preparation of a protective ileostomy were performed. In the histopathological study of the surgical piece, he reported tumor-free surgical edges and 38 mesorectal nodes negative for malignancy (pT2 N0 Mx). Ileostomy closure was performed 2 months after the intervention with favorable evolution and there was fecal continence. Conclusions: Time ago, the diagnosis of Rectal cancer meant the amputation of the organ and the sphincter apparatus with a definitive colostomy, compromising quality of life and morbidity. Current laparoscopic approach techniques allow a better mesorectal resection, obtaining optimal oncological results and adequate restitution of intestinal transit with primary anastomosis and preservation of the sphincter apparatus. Despite the technological evolution in terms of diagnostic means, it is important to improve the protocols for an adequate clinical staging of rectal tumors.