title: Chemoradiotherapy followed by restorative proctocolectomy with partial intersphincteric resection for advanced rectal cancer associated with ulcerative colitis: report of a case.
abstract: The role of restorative proctocolectomy with ileal J-pouch anal anastomosis (IPAA) is uncertain for patients with ulcerative colitis (UC), when advanced lower rectal cancer is diagnosed. We report what to our knowledge is the first documented case of successful preoperative chemoradiotherapy followed by IPAA with partial intersphincteric resection of advanced rectal cancer associated with UC. A 59-year-old woman with a 24-year history of extensive UC was found to have advanced rectal cancer located 2 cm from the anal verge. She underwent preoperative conventional chemoradiotherapy followed by restorative proctocolectomy with total mesorectal excision. The procedure included intersphincteric resection of one quadrant and construction of an IPAA with diverting ileostomy. The postoperative course was uneventful, and the ileostomy was closed 6 months after the initial surgery. The patient was doing well with good pouch function and no evidence of recurrent disease 1 year after her initial surgery.
authors.affiliation: Division of Reparative Medicine, Department of Gastrointestinal and Pediatric Surgery, Institute of Life Sciences, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan, yasinoue@clin.medic.mie-u.ac.jp.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Inoue
authors.forename: Toshimitsu
authors.initials: T
authors.lastname: Araki
authors.forename: Yoshinaga
authors.initials: Y
authors.lastname: Okugawa
authors.forename: Aya
authors.initials: A
authors.lastname: Kawamoto
authors.forename: Junichiro
authors.initials: J
authors.lastname: Hiro
authors.forename: Yuji
authors.initials: Y
authors.lastname: Toiyama
authors.forename: Koji
authors.initials: K
authors.lastname: Tanaka
authors.forename: Keiichi
authors.initials: K
authors.lastname: Uchida
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Mohri
authors.forename: Masato
authors.initials: M
authors.lastname: Kusunoki
mesh_terms: D000230:Adenocarcinoma / Q000150:complications* / Q000628:therapy*; D001003:Anal Canal / Q000601:surgery; D000714:Anastomosis, Surgical; D059248:Chemoradiotherapy; D003093:Colitis, Ulcerative / Q000150:complications*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007082:Ileum / Q000601:surgery; D008875:Middle Aged; D011300:Preoperative Care; D016737:Proctocolectomy, Restorative / Q000379:methods*; D012004:Rectal Neoplasms / Q000150:complications* / Q000628:therapy*; D016896:Treatment Outcome