Transvaginal resection of a rectal leiomyoma: A case report

Matsuhashi,Nobuhisa; Takahashi,Takao; Ichikawa,Kengo; Tanahashi,Toshiyuki; Sasaki,Yoshiyuki; Tanaka,Yoshihiro; Okumura,Naoki; Yamaguchi,Kazuya; Osada,Shinji; Yoshida,Kazuhiro

doi:10.3892/ol.2015.3816

Transvaginal resection of a rectal leiomyoma: A case report

Authors:
- Nobuhisa Matsuhashi
- Takao Takahashi
- Kengo Ichikawa
- Toshiyuki Tanahashi
- Yoshiyuki Sasaki
- Yoshihiro Tanaka
- Naoki Okumura
- Kazuya Yamaguchi
- Shinji Osada
- Kazuhiro Yoshida
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Affiliations: Department of Surgical Oncology, Gifu University School of Medicine, Gifu 501‑1194, Japan
Published online on: October 20, 2015 https://doi.org/10.3892/ol.2015.3816
Pages: 3785-3788

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Abstract

The present study reports the case of a patient with a rectal submucosal tumor (leiomyoma) that was resected transvaginally. A 51‑year‑old female presented with a rectal submucosal tumor on the anterior wall of the lower rectum, located within 3 cm of the anal verge. This location would normally require intersphincteric or abdominal perineal resection. However, in order to minimize the invasiveness of the treatment and reduce post‑operative morbidity, transvaginal resection and laparoscopic diverting ileostomy were performed instead. With the patient under general anesthesia, the posterior vaginal mucosa was incised vertically. The tumor was then excised en bloc with the overlying rectovaginal septum and rectal submucosal tumor. A primary repair of the defect and a diverting stoma were performed. The procedure did not present any complications, and the patient was discharged on day 10 post‑surgery. The diverting stoma was closed 3 months later, and the sphincter function of the patient following surgery was monitored by manometry. The results of the manometric tests indicated that the patient did not suffer from fecal incontinence. In addition, the patient did not experience anal dysfunction or discomfort following the surgical procedure.

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1	Hatch KF, Blanchard DK, Hatch GF III, Wertheimer-Hatch L, Davis GB, Foster RS Jr and Skandalakis JE: Tumors of the rectum and anal canal. World J Surg. 24:437–443. 2000. View Article : Google Scholar : PubMed/NCBI
2	Anderson PA, Dockerty MB and Buie LA: Myomatous tumors of the rectum (leiomyomas and myosarcomas). Surgery. 28:642–650. 1950.PubMed/NCBI
3	Serra J, Ruiz M, Lloveras B, Guillaumes S, Garriga J and Trias R: Surgical outlook regarding leiomyoma of the rectum. Report of three cases. Dis Colon Rectum. 32:884–887. 1989. View Article : Google Scholar : PubMed/NCBI
4	Yasuda K, Nakajima M, Yoshida S, Kiyota K and Kawai K: The diagnosis of submucosal tumors of the stomach by endoscopic ultrasonography. Gastrointest Endosc. 35:10–15. 1989. View Article : Google Scholar : PubMed/NCBI
5	Miettinen M, Furlong M, Sarlomo-Rikala M, Burke A, Sobin LH and Lasota J: Gastrointestinal stromal tumors, intramural leiomyomas, and leiomyosarcomas in the rectum and anus: A clinicopathologic, immunohistochemical, and molecular genetic study of 144 cases. Am J Surg Pathol. 25:1121–1133. 2001. View Article : Google Scholar : PubMed/NCBI
6	Fujimoto Y, Akiyoshi T, Kuroyanagi H, Konishi T, Ueno M, Oya M and Yamaguchi T: Safety and feasibility of laparoscopic intersphincteric resection for very lower rectal cancer. J Gastrointest Surg. 14:645–650. 2010. View Article : Google Scholar : PubMed/NCBI
7	Hashimoto H, Shiokawa H, Funahashi K, Saito N, Sawada T, Shirouzu K, Yamada K, Sugihara K, Watanabe T, Sugita A, et al: Development and validation of a modified fecal incontinence quality of life scale for Japanese patients after inter-sphincteric resection for very low rectal cancer. J Gastroenterol. 45:928–935. 2010. View Article : Google Scholar : PubMed/NCBI
8	Fu T, Liu B, Zhang S, Wang D and Zhang L: Trans-vaginal local excision of rectal carcinoma. Curr Surg. 60:538–542. 2003. View Article : Google Scholar : PubMed/NCBI
9	Rullier E, Laurent C, Carles J, Saric J, Michel P and Parneix M: Local recurrence of low rectal cancer after abdominoperineal and anterior resection. Br J Surg. 84:525–528. 1997. View Article : Google Scholar : PubMed/NCBI
10	Wibe A, Syse A, Andersen E, Tretli S, Myrvold HE and Søreide O: Norwegian Rectal Cancer Group: Oncological outcomes after total mesorectal excision for cure for cancer of the lower rectum: Anterior vs. abdominoperineal resection. Dis Colon Rectum. 47:48–58. 2004. View Article : Google Scholar : PubMed/NCBI
11	Sasaki K, Gotoh Y, Nakayama Y, Hayasaka H, Ishiyama Y and Miyashita H: Leiomyoma of the rectum. Int Surg. 70:149–152. 1985.PubMed/NCBI
12	Kusminsky RE and Bailey W: Leiomyomas of the rectum and anal canal: Report of six cases and review of the literature. Dis Colon Rectum. 20:580–599. 1977. View Article : Google Scholar : PubMed/NCBI
13	Vorobyov GI, Odaryuk TS, Kapuller LL, Shelygin YA and Kornyak BS: Surgical treatment of benign, myomatous rectal tumors. Dis Colon Rectum. 35:328–331. 1992. View Article : Google Scholar : PubMed/NCBI
14	Visser BC, Varma MG and Welton ML: Local therapy for rectal cancer. Surg Oncol. 10:651–652. 2001. View Article : Google Scholar
15	Hellan M and Maker VK: Trans-vaginal excision of a large rectal stromal tumor: An alternative. Am J Surg. 191:121–123. 2006. View Article : Google Scholar : PubMed/NCBI
16	Hara M, Takayama S, Arakawa A, Sato M, Nagasaki T and Takeyama H: Trans-vaginal resection of a rectal gastrointestinal stromal tumor. Surg Today. 42:909–912. 2012. View Article : Google Scholar : PubMed/NCBI
17	Jorge JM, Wexner SD, Morgado PJ Jr, James K, Nogueras JJ and Jagelman DG: Optimization of sphincter function after the ileoanal reservoir procedure. A prospective, randomized trial. D is Colon Rectum. 37:419–423. 1994. View Article : Google Scholar