Extended abdominoperineal resection with partial prostatectomy for T3 rectal cancer.
OBJECTIVE
To describe and discuss extended abdominoperineal resection with partial prostatectomy using the ultrasonic harmonic scalpel as an alternative to total pelvic exenteration in lower rectal T3 cancer contiguous with the prostate.


METHODS
Extended abdominoperineal resection with partial prostatectomy was performed in 4 patients with lower rectal clinical stage T3 cancer contiguous with the prostate using the ultrasonic harmonic scalpel. The ultrasonic harmonic scalpel permitted en bloc dissection of the rectum and the posterior part of the prostate, removing all tumor and disruption of the normal urinary stream.


RESULTS
Blood loss ranged from 600 to 2500 mL. The final pathologic stage was T2 in 1, T3 in 2 and T4 in 1 patient, and the surgical margins were clear in all patients. Urethral injury occurred in 1 patient, and 2 patients had postoperative urinary dysfunction. No patients required a urinary stoma or suffered recurrence.


CONCLUSIONS
Extended abdominoperineal resection with partial prostatectomy using the ultrasonic harmonic scalpel is an attractive alternative to total pelvic exenteration for patients with lower rectal T3 cancer contiguous with the prostate.
Gastroenterological Center, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama 232-0024, Japan. ikeycu2s@urahp.yokohama-cu.ac.jp
Hideyuki
H
Ike
Hiroshi
H
Shimada
Shouichi
S
Fujii
Nobuyuki
N
Kamimukai
Takashi
T
Ohshima
Toshio
T
Imada
D000368:Aged; D016063:Blood Loss, Surgical; D013505:Digestive System Surgical Procedures; D006801:Humans; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D010385:Pelvic Exenteration; D011467:Prostate / Q000601:surgery*; D012004:Rectal Neoplasms / Q000601:surgery*