Transanal total mesorectal excision as a surgical procedure for diffuse cavernous hemangioma of the rectum: A case report

Xian-Rui Wu; Wei-Wen Liang; Xing-Wei Zhang; Liang Kang; Ping Lan

doi:10.1016/j.ijscr.2017.08.010

Transanal total mesorectal excision as a surgical procedure for diffuse cavernous hemangioma of the rectum: A case report

Int J Surg Case Rep. 2017:39:164-167. doi: 10.1016/j.ijscr.2017.08.010. Epub 2017 Aug 10.

Authors

Xian-Rui Wu¹, Wei-Wen Liang¹, Xing-Wei Zhang¹, Liang Kang², Ping Lan³

Affiliations

¹ Department of Colorectal Surgery, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou City, Guangdong Province, PR China.
² Department of Colorectal Surgery, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou City, Guangdong Province, PR China. Electronic address: lanping@mail.sysu.edu.cn.
³ Department of Colorectal Surgery, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou City, Guangdong Province, PR China; Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou City, Guangdong Province, PR China.

Abstract

Background: The safety and feasibility of transanal total mesorectal excision (TaTME) were demonstrated in the management of rectal cancer. However, its role in the management of patients with diffuse cavernous hemangioma of the rectum (DCHR) has not been evaluated.

Methods: A female patient with DCHR was admitted to our hospital. Colonoscopy, magnetic resonance imaging (MRI), abdominal computed tomography (CT) and arteriography were performed. Lesions were detected in mesorectum and rectal wall extending from the dentate line to 5cm proximally. TaTME with a protecting loop ileostomy were performed. The research work has been reported in line with the SCARE criteria Agha et al., 2016 [1].

Results: TaTME and a protecting loop ileostomy were safely performed, with an intact mesorectal specimen being harvested. The entire procedure took 348min. The estimated blood loss was 100ml. The patient recovered uneventfully. Her symptom of painless rectal bleeding was resolved satisfactorily following the surgery. The histopathological evaluation confirmed the diagnosis of DCHR.

Conclusions: TaTME appears to be a safe and feasible procedure for patients with DCHR in experienced hands.

Keywords: Case report; Diffuse cavernous hemangioma of the rectum; Natural orifice translumenal endoscopic surgery; Transanal total mesorectal excision (TaTME).