Preoperative rectal tumor embolization as an adjunctive tool for bloodless abdominoperineal excision: A case report.

Abstract

BACKGROUND:

Abdominoperineal excision (APE)-related hemorrhage can be challenging due to difficult access to pelvic organs and the risk of massive blood loss. The objective of the present study was to demonstrate the use of preoperative embolization (PE) as a strategy for blood preservation in a patient with a large low rectal tumor with a high risk of bleeding, scheduled for APE.

CASE SUMMARY:

A 56-year-old man presented to our institution with a one-year history of anal bleeding and rectal tenesmus. The patient was diagnosed with bulky adenocarcinoma limited to the rectum. As the patient refused any clinical treatment, surgery without previous neoadjuvant chemoradiation was indicated. The patient underwent a tumor embolization procedure, two days before surgery performed via the right common femoral artery. The tumor was successfully devascularized and no major bleeding was noted during APE. Postoperative recovery was uneventful and a one-year follow-up showed no signs of recurrence.

CONCLUSION:

Therapeutic tumor embolization may play a role in bloodless surgeries and increase surgical and oncologic prognoses. We describe a patient with a bulky low rectal tumor who successfully underwent preoperative embolization and bloodless abdominoperineal resection.

• Authors: Marley Ribeiro Feitosa, Lucas Fernandes de Freitas, Antonio Balestrim Filho, Guilherme Seizem Nakiri, Daniel Giansante Abud, Ligia Magnani Landell, Mariângela Ottoboni Brunaldi, Jose Joaquim Ribeiro da Rocha, Omar Feres, Rogério Serafim Parra
• Journal: World journal of clinical oncology (World J Clin Oncol) Vol. 11 Issue 12 Pg. 1070-1075 (Dec 24 2020) ISSN: 2218-4333 [Print] United States
• PMID: 33437668 (Publication Type: Case Reports)
• Copyright: ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.