A Case of Abdominoperineal Resection with Prostatectomy for Lower Rectal Cancer Infiltrating into the Prostate

Toshihiro Muto, Takashi Hirai, Norio Hayashi*, Yukihide Kanemitu, Koji Komori, Masataka Ando and Tomoyuki Kato

Department of Gastroenterological Surgery and Department of Urology*, Aichi Cancer Center Hospital

A 58-year-old man with bloody stool diagnosed with lower rectal cancer by a local physician and referred to our hospital was found to have a hemicircumferential type 2 lesion mainly located in the anterior wall of the rectum. The lower edge of the tumor was 2 cm above the dentate line. Computed tomography, magnetic resonance imaging, and endoscopic ultrasonography suggested infiltration into the left side of the prostate. Because no distant metastases were found preoperative preoperatively, we conducted curative abdominoperineal resection, prostatectomy, and lateral lymph node dissection, pathologically confirming infiltration into the prostate and a negative surgical margin, especially toward the left pelvic wall. Dehiscence of the vesicourethral anastomosis had occurred but improved with conservative treatment. Although the left pelvic nerve plexus was resected, bladder function was preserved. We reported this complicated but beneficial procedure for lower rectal cancer infiltration only into the prostate, which ensures negative surgical margin and obviates the need for total pelvic exenteration.

Key words
rectal cancer, abdominoperineal resection, prostatectomy

Reprint requests
Toshihiro Muto Department of Gastroenterological Surgery, Aichi Cancer Center Hospital
1-1 Kanokoden, Chikusa-ku, Nagoya, 464-8681 JAPAN

Accepted
November 22, 2006

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