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Synchronous rectal adenocarcinoma and anal canal adenocarcinoma

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Frontiers of Medicine 2007年第3期1卷 333-337页

作者： GU Jin LI Jiyou YAO Yunfeng LU Aiping WANG Hongyi Department of Surgery Beijing Cancer HospitalBeijing Institute for Cancer ResearchPeking University School of OncologyBeijing 100036China Department of Pathology Beijing Cancer HospitalBeijing Institute for Cancer ResearchPeking University School of OncologyBeijing 100036China

It is difficult to distinguish a rectal carcinoma with anal metastases from coexistent synchronous anorectal *** therapeutic strategy for rectal and anal carcinoma is so different that it should be clearly ***,we report on the case of a 63-year-old man who presented with an upper-third rectal *** months after resection,he developed an adenocarcinoma in the anal *** histological slides of both tumors were reviewed and immunohistochemical studies for cytokeratins(CKs)7 and 20 were *** index tumor demonstrated CK 7–/CK 20+and the second showed CK7+/CK20+.For this reason,we believe the present case had synchronous adenocarcinomas arising from anal canal and the rectum *** is very important to differentiate the anorectal lesions pathologically because of the impact on the therapeutic options available,especially for the lesion arising in the anal canal.

关键词： rectal neoplasms neoplasms,multiple primary anal canal

Tubulovillous adenoma of anal canal: A case report

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World Journal of Gastroenterology 2006年第11期12卷 1780-1781页

作者： Bhupinder S Anand Gordana Verstovsek George Cole Departments of Medicine Pathology and Surgery Michael E.DeBakey Veterans Administration Medical Center and Baylor College of MedicineHoustonTexasUnited States

Tumors arising from the anal canal are usually of epithelial origin and are mostly squamous cell carcinoma or basal cell carcinoma. We present a case of benign anal adenomas arising from the anus, an extremely rare diagnosis. A 78-year-old white man presented with rectal bleeding of several months duration. Examination revealed a 4 cm friable mass attached to the anus by a stalk. At surgery, the mass was grasped with a Babcock forceps and was resected using electrocautery. Microscopic examination revealed a tubulovillus adenoma with no areas of high grade dysplasia or malignant transformation. The squamocolumnar junction was visible at the edges of the lesion confirming the anal origin of the tumor. We believe the tubulovillus adenoma arose from either an anal gland or its duct that opens into the anus. Although seen rarely, it is important to recognize and treat these tumors at an early stage because of their potential to transform into adenocarcinoma.

关键词： Tubulovillous adenoma anal canal

Infiltrating adenocarcinoma arising in a villous adenoma of the anal canal

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World Journal of Gastroenterology 2009年第28期15卷 3560-3564页

作者： Marni Colvin Aris Delis Erika Bracamonte Hugo Villar Luis R Leon Jr Department of Surgical Oncology University Medical Center Tucson AZ 85724 United States Department of Pathology University Medical Center Tucson AZ 85724 United States Department of Vascular Surgery Tucson Medical Center Tucson AZ 85712 Department of Vascular Surgery University Medical Center Tucson AZ 85724 United States

Primary neoplasms arising in the anal canal are relatively *** particular, adenomas and adenocarcinomas are distinctly rare entities in this *** describe an infiltrating, well-differentiated adenocarcinoma arising in a villous adenoma from the distal anal canal, in an otherwise healthy patient at low risk for gastrointestinal *** is the case of an octogenarian man with a several year history of hemorrhoids and intermittent rectal bleeding, more recently complaining of continuous *** revealed a blood-covered pedunculated mass with a long stalk protruding from the *** lesion was amputated at the *** evaluation revealed an infiltrating well-differentiated adenocarcinoma, arising from a villous *** was further evaluated under anesthesia and complete excision of distal anal tissue was *** report is the f irst describing the possible malignant degeneration of a villous adenoma in the anal canal.

关键词： anal adenocarcinoma anal canal Villousadenoma

Cloacogenic carcinoma of anal canal:two case reports and review of Chinese literature

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The Chinese-German Journal of Clinical Oncology 2010年第5期9卷 302-304页

作者： Shaoliang Han Sheqing Ji Shengcong Guo Wangyong Li Department of General Surgery the First Affiliated Hospital of Wenzhou Medical College Wenzhou 325000China Department of General Surgery Henan Provincial Tumor Hospital Zhengzhou 450008 China

Cloacogenic carcinoma is a rare tumor of rectum and anus,which originating from epithelium of the anal transition zone of embryonic *** described the medical history of two patients with cloacogenic carcinoma of anal canal and reviewed of the Chinese literature(January 1994 to March 2009).In conclusion,cloacogenic carcinoma of anal canal can obtain good results with a abdominoperineal excision(APE).

关键词： anal canal basaloid squamous cancer cloacogenic carcinoma

Surgical salvage therapy of anal cancer

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World Journal of Gastroenterology 2004年第3期10卷 424-426页

作者： Yue-KuiBai Wen-LanCao Ji-DongGao JunLiang Yong-FuShao DepartmentofGeneralSurgicalOncology CancerHospitalofChineseAcademyofMedicalSciencesPekingUnionMedicalCollegeBeijing100021China DepartmentofRadiotherapy CentralHospitalYuncheng044000ShanxiProvinceChina

AIM:To evaluate the results of salvage resection in the management of persistent or locally recurrent anal canal ***: Details of all patients with anal canal cancer treated from 1978 to 1994 at Cancer Hospital of Chinese Academy of Medical Sciences (CAMS) were reviewed *** patients who presented with persistent or locally recurrent anal canal cancer received salvage surgery. Before surgery all of the patients had received radiotherapy alone as their primary ***:Of the 16 patients, 14 received salvage abdominoperineal resection (APR) and two had transanal local excision. There were no deaths attributable to *** healing of the perineal wound occurred in eight patients. Complications unrelated to the perineal wound were found in five patients. The median follow-up time was 120 (range 5-245) months after salvage surgery. Nine patients died of disease progression, with a median survival time of 16 (range 5-27) months. Six patients had a long-term ***:Salvage resection after radiotherapy can yield a long-time survival in selected patients with anal canal cancer. However it offers little hope to patients with T4 and/or N2-3 tumors.

关键词： Salvage Therapy Abdomen Aged anal canal Anus Neoplasms Female Humans Male Middle Aged Perineum Survival analysis

Hypothesized summative anal physiology score correlates but poorly predicts incontinence severity

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World Journal of Gastroenterology 2017年第31期23卷 5732-5738页

作者： Christopher J Young Assad Zahid Cherry E Koh Jane M Young Department of Colorectal Surgery University of Sydney RPAH Medical Centre Discipline of Surgery University of Sydney Surgical Outcome Research Centre(SOu RCe) Royal Prince Alfred HospitalUniversity of Sydney School of Public health University of Sydney

To explore the relationship between such a construct and an existing continence score. METHODSA retrospective study of incontinent patients who underwent anal physiology (AP) was performed. AP results and Cleveland Clinic Continence Scores (CCCS) were extracted. An anal physiology score (APS) was developed using maximum resting pressures (MRP), anal canal length (ACL), internal and external sphincter defects and pudendal terminal motor latency. Univariate associations between each variable, APS and CCCS were assessed. Multiple regression analyses were performed. RESULTSOf 508 (419 women) patients, 311 had both APS and CCCS measured. Average MRP was 51 mmHg (SD 23.2 mmHg) for men and 39 mmHg (19.2 mmHg) for women. Functional ACL was 1.7 cm for men and 0.7 cm for women. Univariate analyses demonstrated significant associations between CCCS and MRP (P = 0.0002), ACL (P = 0.0006) and pudendal neuropathy (P < 0.0001). The association between APS and CCCS was significant (P < 0.0001) but accounted for only 9.2% of the variability in CCCS. Multiple regression showed that the variables most useful in predicting CCCS were external sphincter defect, pudendal neuropathy and previous pelvic surgery, but only improving the scores predictive ability to 12.5%. CONCLUSIONThis study shows that the ability of AP tests to predict continence scores improves when considered collectively, but that a constructed summation model before and after multiple regression is poor at predicting the variability in continence scores.

关键词： Incontinence anal physiology anal canal anal ultrasound Manometry Electromyography

Internal hemorrhoid harboring adenocarcinoma:A case report

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World Journal of Gastrointestinal Oncology 2021年第1期13卷 87-91页

作者： Michael L Caparelli Jason C Batey Anisha Tailor Timothy Braverman Cory Barrat of Surgery The Jewish HospitalCincinnatiOH 45236United States Department of Pathology The Jewish HospitalCincinnatiOH 45236United States

BACKGROUND The incidence of carcinoma found within an internal hemorrhoid specimen is exceptionally ***,the presence of primary anal canal adenocarcinoma within internal hemorrhoids is even more *** describe a case in which anal canal adenocarcinoma was found within an internal hemorrhoidectomy specimen and perform a review of the current *** SUMMARY The patient was a 79-year-old male who presented with rectal bleeding and was found to have large thrombosed internal hemorrhoids during screening *** patient subsequently underwent a three-column *** analysis revealed one of three specimens containing a 1.5 cm moderate-to-poorly differentiated adenocarcinoma of anal origin with superficial submucosal *** three-month follow up,he was taken to the operating theatre for biopsy and re-excision of his non-healing wound,which showed no *** wound has since healed and he was cancer free at ten-month follow *** When faced with primary anal canal adenocarcinoma an interdisciplinary approach to treatment should be *** pathological analysis of hemorrhoidectomy specimens may be beneficial due to the severity of anal canal carcinomas if left undiagnosed and untreated in a timely manner.

关键词： Hemorrhoidectomy Adenocarcinoma Colorectal anal canal Oncology Hematochezia Case report

Is anoplasty superior to scar revision surgery for posthemorrhoidectomy anal stenosis?Six years of experience

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World Journal of Clinical Cases 2022年第22期10卷 7698-7707页

作者： Yu-Tse Weng Kuan-Jung Chu Kuan-Hsun Lin Chun-Kai Chang Jung-Cheng Kang Chao-Yang Chen Je-Ming Hu Ta-Wei Pu Division of Plastic and Reconstructive Surgery Department of SurgeryTri-Service General HospitalNational Defense Medical CenterTaipei 114Taiwan National Defense Medical Center Taipei 114Taiwan Division of Thoracic Surgery Department of SurgeryTri-Service General HospitalNational Defense Medical CenterTaipei 114Taiwan Division of Plastic and Reconstructive Surgery Department of SurgeryZuoying BranchKaohsiung Armed Forces General HospitalKaohsiung 813Taiwan Division of Colon and Rectal Surgery Department of SurgeryTaiwan Adventist HospitalTaipei 105Taiwan Division of Colon and Rectal Surgery Department of SurgeryTri-Service General HospitalNational Defense Medical CenterTaipei 114Taiwan Division of Colon and Rectal Surgery Department of SurgerySongshan branchTri-Service General HospitalNational Defense Medical CenterTaipei 105Taiwan

BACKGROUND anal stenosis is a rare but frustrating condition that usually occurs as a complication of *** severity of anal stenosis can be classified into three categories:mild,moderate,and *** are two main surgical treatments for this condition:scar revision surgery and anoplasty;however,no studies have compared these two approaches,and it remains unclear which is preferrable for stenoses of different *** To compare the outcomes of scar revision surgery and double diamond-shaped flap *** Patients with mild,moderate,or severe anal stenosis following hemorrhoidectomy procedures who were treated with either scar revision surgery or double diamond-shaped flap anoplasty at our institution between January 2010 and December 2015 were investigated and *** severity of stenosis was determined via anal examination performed digitally or using a Hill-Ferguson *** explored patient characteristics included age,sex,preoperative severity of anal stenosis,preoperative symptoms,and preoperative adjuvant therapy;moreover,their postoperative quality of life was measured using a 10-point *** underwent proctologic follow-up examinations one,two,and four weeks after *** We analyzed 60 consecutive patients,including 36 men(60%)and 24 women(40%).The mean operative time for scar revision surgery was significantly shorter than that for double diamondshaped flap anoplasty(10.14±2.31[range:7-15]min vs 21.62±4.68[range:15-31]min;P<0.001).The average of length of hospital stay was also significantly shorter after scar revision surgery than after anoplasty(2.1±0.3 vs 2.9±0.4 d;P<0.001).Postoperative satisfaction was categorized into four groups:45 patients(75%)reported excellent satisfaction(scores of 8-10),13(21.7%)reported good satisfaction(scores of 6-7),two(3.3%)had no change in satisfaction(scores of 3-5),and none(0%)had scores indicating poor satisfaction(1-2).As such,most patients were satisfied wi

关键词： anal canal Anoplasty Scar revision Stenosis Surgery-induced tissue adhesions Surgical flaps

Modified stapled hemorrhoidopexy for lower postoperative stenosis: A five-year experience

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World Journal of Gastrointestinal Surgery 2024年第9期16卷 2787-2795页

作者： Yu-Hong Liu Tzu-Chiao Lin Chao-Yang Chen Ta-Wei Pu Division of Colon and Rectal Surgery Department of SurgeryTri-Service General HospitalNational Defense Medical CenterTaipei 105TaiwanChina Division of Colon and Rectal Surgery Department of SurgeryTri-Service General Hospital Songshan BranchNational Defense Medical CenterTaipei 105TaiwanChina

BACKGROUND Stapled hemorrhoidopexy(SH)is currently a widely accepted method for treating the prolapse of internal *** anal stenosis is a critical complication of SH.A remedy for this involves the removal of the circumferential staples of the anastomosis,followed by the creation of a hand-sewn *** studies have reported modified SH procedures to improve *** hypothesized that our modified SH technique may help reduce complications of anal stenosis after *** To compare outcomes of staple removal at the 3-and 9-o’clock positions during modified SH in patients with mixed *** This was a single-center,retrospective,observational *** with grade III or IV hemorrhoids who underwent standard or modified SH at our colorectal center between January 1,2015,and January 1,2020,were *** operation time,blood loss,length of hospital stay,and incidence of minor or major complic-ations were *** Patients with grade III or IV hemorrhoids who underwent standard or modified SH at our colorectal center between January 1,2015 and January 1,2020,were *** time,blood loss,length of hospital stay,and incidence of minor or major complications were *** investigated 187 patients(mean age,50.9 years)who had undergone our modified SH and 313 patients(mean age,53.0 years)who had undergone standard *** the modified SH group,54%of patients had previously undergone surgical intervention for hemorrhoids,compared with the 40.3%of patients in the standard SH *** modified SH group included five(2.7%)patients with anal stenosis,while 21(6.7%)patients in the standard SH group had complications of anal *** was a significant relationship between the rate of postoperative anal stenosis and the modified SH:0.251(0.085-0.741)and 0.211(0.069-0.641)in multiple regression *** modified SH technique is a safe surgical method for advanced grade hemorrhoids and might result in

关键词： anal canal Hemorrhoids Prolapse Stapled hemorrhoidopexy Postoperative anal stenosis Modified stapled hemorrhoidopexy