Combined Pubic Arch and Ischial Bone Resection for Metachronous and Frequent Local Recurrences of Rectal Cancer.


Journal

Anticancer research
ISSN: 1791-7530
Titre abrégé: Anticancer Res
Pays: Greece
ID NLM: 8102988

Informations de publication

Date de publication:
Jul 2024
Historique:
received: 22 04 2024
revised: 23 05 2024
accepted: 04 06 2024
medline: 27 6 2024
pubmed: 27 6 2024
entrez: 26 6 2024
Statut: ppublish

Résumé

Complete surgical resection with negative margins remains the cornerstone for curative treatment of rectal cancer; however, local recurrence can pose a significant challenge. Herein, we aimed to introduce a novel surgical technique for combined resection of the pubic arch and ischial bone in the context of treating recurrent rectal cancer. We present a case of a patient with a fourth local recurrence of rectal cancer, with no evidence of distant metastasis. The tumor directly invaded the posterior wall of the pubic arch. To achieve complete tumor resection, an osteotomy was performed using a thread wire saw at the bilateral pubic rami and ischial bones. Intraoperative frozen section analysis (rapid tissue examination) was conducted on tissue samples from the lateral margins of the planned osteotomy line. Samples were negative for adenocarcinoma (cancerous cells). The combined resection of the pubic arch and ischial bone was successfully performed with negative margins for adenocarcinoma, as confirmed by frozen section analysis. Mastery of the surgical technique for combined resection of the pubic arch and ischial bone may be clinically significant for achieving complete resection in cases of multiple resections for locally recurrent rectal cancer.

Sections du résumé

BACKGROUND/AIM OBJECTIVE
Complete surgical resection with negative margins remains the cornerstone for curative treatment of rectal cancer; however, local recurrence can pose a significant challenge. Herein, we aimed to introduce a novel surgical technique for combined resection of the pubic arch and ischial bone in the context of treating recurrent rectal cancer.
CASE REPORT METHODS
We present a case of a patient with a fourth local recurrence of rectal cancer, with no evidence of distant metastasis. The tumor directly invaded the posterior wall of the pubic arch. To achieve complete tumor resection, an osteotomy was performed using a thread wire saw at the bilateral pubic rami and ischial bones. Intraoperative frozen section analysis (rapid tissue examination) was conducted on tissue samples from the lateral margins of the planned osteotomy line. Samples were negative for adenocarcinoma (cancerous cells). The combined resection of the pubic arch and ischial bone was successfully performed with negative margins for adenocarcinoma, as confirmed by frozen section analysis.
CONCLUSION CONCLUSIONS
Mastery of the surgical technique for combined resection of the pubic arch and ischial bone may be clinically significant for achieving complete resection in cases of multiple resections for locally recurrent rectal cancer.

Identifiants

pubmed: 38925850
pii: 44/7/3205
doi: 10.21873/anticanres.17136
doi:

Types de publication

Journal Article Case Reports

Langues

eng

Sous-ensembles de citation

IM

Pagination

3205-3211

Informations de copyright

Copyright © 2024 International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

Auteurs

Koji Komori (K)

Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Aichi, Japan; kkomori@aichi-cc.jp.

Masahiro Yoshida (M)

Department of Orthopedic Surgery, Aichi Cancer Center Hospital, Aichi, Japan.

Satoshi Tsukushi (S)

Department of Orthopedic Surgery, Aichi Cancer Center Hospital, Aichi, Japan.

Takashi Kinoshita (T)

Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Aichi, Japan.

Yusuke Sato (Y)

Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Aichi, Japan.

Akira Ouchi (A)

Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Aichi, Japan.

Seiji Ito (S)

Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Aichi, Japan.

Tetsuya Abe (T)

Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Aichi, Japan.

Kazunari Misawa (K)

Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Aichi, Japan.

Yuichi Ito (Y)

Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Aichi, Japan.

Seiji Natsume (S)

Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Aichi, Japan.

Eiji Higaki (E)

Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Aichi, Japan.

Tomonari Asano (T)

Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Aichi, Japan.

Masataka Okuno (M)

Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Aichi, Japan.

Hironori Fujieda (H)

Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Aichi, Japan.

Hisahumi Saito (H)

Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Aichi, Japan.

Kiyoshi Narita (K)

Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Aichi, Japan.

Takuya Kitahara (T)

Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Aichi, Japan.

Takaaki Hanazawa (T)

Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Aichi, Japan.

Hidenori Ojio (H)

Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Aichi, Japan.

Masashi Negita (M)

Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Aichi, Japan.

Hironobu Yasuoka (H)

Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Aichi, Japan.

Yasuhiro Shimizu (Y)

Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Aichi, Japan.

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