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CC BY-NC-ND 4.0 · Journal of Coloproctology 2019; 39(02): 174-177
DOI: 10.1016/j.jcol.2018.11.004
Case Report

A combination treatment of transanal total mesorectal excision and Turnbull–Cutait abdominoperineal pull-through procedure for a low rectal cancer

Um tratamento combinando a excisão total do mesorreto por via transanal e o “pull-through” abdominoperineal de Turnbull-Cutait para câncer de reto baixo
Suleyman Utku Celik 
a   Gulhane Training and Research Hospital, Clinic of General Surgery, Ankara, Turkey
,
Omer Arda Cetinkaya
b   Ankara University School of Medicine, Department of General Surgery, Ankara, Turkey
,
Furkan Atakan Akin
b   Ankara University School of Medicine, Department of General Surgery, Ankara, Turkey
,
Stéfano do Amaral Fiúza
c   Hospital Adventista Silvestre, Rio de Janeiro, RJ, Brazil
,
Ibrahim Ethem Gecim 
b   Ankara University School of Medicine, Department of General Surgery, Ankara, Turkey
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Abstract

Surgical treatment for low rectal cancer has changed dramatically during the preceding several decades, and the optimal surgical approach remains incompletely developed. Transanal total mesorectal excision is likely the most promising approach for the dissection of the distal part of the mesorectum in a manner that allows for a technically easy and oncologically safe operation. Long after it was first described, the Turnbull–Cutait abdominoperineal pull-through procedure has recently been reintroduced in surgical practice for the treatment of patients with complex anorectal conditions. The current report describes a case of distal rectal cancer involving successful surgical treatment with a combination of the two aforementioned methods and patient discharge without a diverting stoma.

Resumo

O tratamento cirúrgico para o câncer de reto baixo mudou drásticamente durante as últimas décadas, mas uma abordagem cirúrgica de excelência ainda continua incompletamente desenvolvida. A excisão total do mesorreto por via transanal parece ser a abordagem mais promissora para a dissecção da parte distal do mesorreto de forma a assegurar uma cirurgia oncológicamente segura com uma técnica simples. Muito depois de sua descrição, o pull-through abdominoperineal de Turnbull-Cutait tem sido reintroduzido na prática cirúrgica para o tratamento de pacientes com enfermidades anorretais complexas. Este relato descreve um caso de câncer de reto baixo que se beneficiou de um tratamento cirúrgico bem sucedido a partir da combinação das duas técnicas supracitadas com o paciente recebendo alta hospitalar sem ostomia de proteção.

Keywords

Colorectal cancer - Delayed coloanal anastomosis - Transanal total mesorectal excision - Turnbull–Cutait procedure

Palavras-chave

Anastomose coloanal tardia - Câncer colorretal - Excisão total do mesorreto transanal - Técnica de Turnbull-Cutait


Publication History

Received: 14 August 2018

Accepted: 26 November 2018

Article published online:
08 March 2021

© 2018. Sociedade Brasileira de Coloproctologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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