Laparoscopic low anterior resection for early rectal cancer.

INTRODUCTION: Early rectal cancer (ERC) is adenocarcinoma that has invaded into, but not extended beyond, the submucosa. Endoscopic or minimal access surgical procedures, such as laparoscopic resection, have emerged as a useful tool in the surgical treatment of such diseases. The aim of this study is to present and analyze the feasibility, the short- and long-term results of laparoscopic colorectal surgery (LCS) in patients with ERC. PATIENTS AND METHODS: Between 2002 and 4/2011, a total of 164 patients with colorectal cancer underwent laparoscopic surgery (LS). Of these, 7 patients (4.2%) had ERC and underwent laparoscopic anterior resection (LAR). The median follow-up was 41 months. RESULTS: The mean operative time was 2.5 h. None of the laparoscopic procedures was converted to open surgery. Liquids and solid food were started on median postoperative days 1 and 3, respectively. The median length of postoperative stay was 5 days. Postoperative complications occurred in 2 patients (28.5%), including wound infection in one patient (14.2%) and atelectasis in one patient (14.2%). None of the patients required an urgent re-operation. There was no mortality related to LS. CONCLUSIONS: LS for ERC can be used as a strategy sited between endoscopic mucosal resection and open anterior resection with beneficial long- and short-term results. It appears as a technically and oncologically safe procedure when performed by surgeons with sufficient experience in laparoscopic techniques.

Breast cancer metastatic to the rectum: a case report.

INTRODUCTION: Patients with breast cancer may present with systemic recurrence in any organ, primarily the bones, lungs, lymph nodes, liver, pleura, and adrenal glands. We report a case of rectal tumor, metastatic from breast cancer, which represents an unusual location of metastasis. CASE PRESENTATION: A 74-year-old woman, operated for lobular breast cancer 5 years ago, but not compliant with the annual follow-up, presented with severe constipation and pseudodiarrhea. Digital examination and anoscopy revealed a mass at the lower rectum, 2 cm distant from the anal verge. CT and MRI scan of the abdomen confirmed this finding and did not reveal metastatic lesions elsewhere. The patient underwent abdominoperineal resection. RESULTS: The postoperative period was uneventful, and the patient was discharged on the 7th postoperative day. The histopathological findings revealed rectal cancer, metastatic from the known invasive lobular breast cancer. CONCLUSIONS: Rectal metastasis from breast cancer is very rare. The presented case emphasizes the need to keep in mind this possibility and at all times associate the emergency condition with the related history of breast cancer.