Three‐dimensional laparoscopy‐assisted bowel resection for cavernous hemangioma of the rectum: Report of two cases

Fu, Zhengwei; Wang, Lixia; Zhang, Zhen‐yu; Luo, Qifeng; Ge, Haiyan

doi:10.1111/ases.12636

Cited by 8 publications

(11 citation statements)

References 10 publications

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“…Mobilization of the entire rectum with intersphincteric resection potentially enables the complete removal of disease tissue with preservation of sphincter function. It is associated with a low recurrence rate and could become the preferred management option of rectal VM 4,10,13 . Recently, robotic and 3‐D laparoscopic techniques have been described 10,22 …”

Section: Discussionmentioning

confidence: 99%

“…However, requiring a permanent colostomy for a benign disease, particularly in young patients, is a major concern. Some have advocated low anterior resection, 1,4,10 but it is associated with a higher recurrence rate mainly due to persistent residual lesions on the remaining rectal wall. 4 Mobilization of the entire rectum with intersphincteric resection potentially enables the complete removal of disease tissue with preservation of sphincter function.…”

Section: Discussionmentioning

confidence: 99%

“…4,10,13 Recently, robotic and 3-D laparoscopic techniques have been described. 10,22 In most cases of VM, the lesion arises from the mesodermal tissue, confining the VM to the mesorectum. As such, there exists a virgin plane between the mesorectal tissue and other adjacent viscera.…”

Section: Discussionmentioning

confidence: 99%

“…There is also considerable ambiguity on the extent of surgery needed-specifically, local excision, anterior resection, or abdominoperineal resection, and both laparoscopic and transanal approaches have been described. 5,[10][11][12] Here, we report a case of rectal VM along with a brief literature review. We emphasize that although total mesorectal excision (TME) has been described for rectal cancer, it may be indicated for benign disease like rectal VM to achieve complete removal of the disease and to minimize intraoperative blood loss.…”

Section: Introductionmentioning

confidence: 99%

“…Moreover, because of the rarity of the disease, the management protocol is not well established. There is also considerable ambiguity on the extent of surgery needed—specifically, local excision, anterior resection, or abdominoperineal resection, and both laparoscopic and transanal approaches have been described 5,10‐12 …”

Section: Introductionmentioning

confidence: 99%

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Laparoscopic total mesorectal excision for rectal venous malformation: A case report with a brief literature review

Bhattacharjee

Karthyarth

Suhani

et al. 2020

Asian J Endoscop Surgery

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Rectal vascular malformation is a rare disease on which few reports have been published. Here, we report the case of a 38-year-old woman who presented with severe weakness, dyspnea, and recurrent episodes of rectal bleeding. Her colonoscopy showed an extensive pigmented lesion in the lower rectum. CT angiography showed diffuse circumferential wall thickening of the rectum, perirectal fat stranding, tiny round foci of calcification, and no arterial feeders. Multiphasic MRI confirmed the diagnosis. The patient underwent a total mesorectal excision with hand-sewn coloanal anastomosis. The venous malformation was confined to the mesorectal tissue. The avascular plane between the ectodermal and mesodermal tissue was well maintained. Blood loss was 200 mL. The patient has had no recurrence of disease in the 18 months since surgery. Although total mesorectal excision is described for rectal cancer, it may be indicated for benign disease like rectal vascular malformation to achieve complete removal of the disease and to minimize intraoperative blood loss.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Laparoscopic total mesorectal excision for rectal venous malformation: A case report with a brief literature review

Bhattacharjee

Karthyarth

Suhani

et al. 2020

Asian J Endoscop Surgery

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Giant rectal vascular malformation: a rare differential diagnosis in rectal bleeding

Schabl,

Connelly,

Steele

et al. 2023

BMJ Case Rep

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Investigations in a woman with prolonged symptoms of laxative-resistant constipation and recurrent rectal bleeding revealed a giant rectal vascular malformation. Colonoscopy and MRI were performed to rule out malignancy and determine differential diagnoses. Repeated tests were necessary due to inconclusive results. After a definite diagnosis, image-guided, transcutaneously administered sclerotherapy was used. The intervention and postoperative course were uneventful. A minimally invasive procedure relieved symptoms and improved quality of life.

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Incidental finding of diffuse cavernous rectal haemangiomatosis during bowel cancer screening

et al. 2019

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BackgroundThis case seeks to highlight to endoscopists a rare benign disorder that may be encountered during endoscopy. Clinicians may be tempted to biopsy, which could lead to a catastrophic gastrointestinal haemorrhage.Case presentationA 66-year-old asymptomatic Caucasian male was referred for colonoscopy with a positive faecal occult blood test as part of the UK national bowel cancer screening programme. Relevant past medical history included atrial fibrillation for which he took Dabigatran. He had a normal haemoglobin, mean cell volume, platelet and clotting function.During colonoscopy, an unusual vascular pattern encompassing the entire rectum extending to the rectosigmoid junction was noted at intubation. The lesion demonstrated confluent circumferential purple discolouration indicating venous blood supply, with heaping up of the mucosa involving the entire rectum and rectosigmoid junction. There was no corresponding history of venothromboembolic disease or liver disease. The patient proceeded to have computed tomography (CT) which revealed a considerably thickened rectosigmoid wall with multiple small rounded punctate calcifications within it, and no other visceral involvement. Subsequent magnetic resonance (MR) scan of the pelvis demonstrated extensive diffuse thickening of the rectum and lower sigmoid with intermediate to high T2 signal, and an internal architecture of multiple ‘grapelike’ lobulations.ConclusionThe findings were consistent with diffuse cavernous haemangiomatosis of the rectum (DCHR), an extremely rare benign submucosal vascular intestinal tumour originating from the dentate line. Misdiagnosis of DCHR is common and the macroscopic appearance of DCHR can mimic varices, haemorrhoids, polyps or proctitis. MR imaging is the gold standard for diagnosis. Common presentation is with haematochezia due to mucosal wall erosion. The treatment of choice for symptomatic DCHR is pull-through transection and colo-anal anastomosis. This case seeks to highlight a rare disorder that can be encountered incidentally during lower GI endoscopy. Injudicious biopsy is potentially catastrophic. In a patient who endoscopically has evidence of a DCHR, we advocate MR pelvis assessment to clarify the nature of the lesion to guide future management if required. The patient discussed remains well, asymptomatic, with no evidence of iron deficiency anaemia.

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Three‐dimensional laparoscopy‐assisted bowel resection for cavernous hemangioma of the rectum: Report of two cases

Cited by 8 publications

References 10 publications

Laparoscopic total mesorectal excision for rectal venous malformation: A case report with a brief literature review

Laparoscopic total mesorectal excision for rectal venous malformation: A case report with a brief literature review

Giant rectal vascular malformation: a rare differential diagnosis in rectal bleeding

Incidental finding of diffuse cavernous rectal haemangiomatosis during bowel cancer screening

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