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Transanal total mesorectal excision for diffuse cavernous hemangioma of the rectum

Ziwei Zeng, Shuangling Luo, Liang Kang. the Sixth Affiliated Hospital, Sun Yat-sen University

Aims: To evaluate the safety and feasibility of transanal total mesorectal excision (TaTME) for diffuse cavernous hemangioma of the rectum (DCHR).

Methods: All DCHR patients who underwent TaTME in our hospital between January 2014 and June 2018 were reviewed.

Results: A total of 7 patients with a diagnosis of DCHR underwent TaTME during the study period. Four patients (57.1%) were male, with a mean age at surgery of …years.. Recurrent painless rectal bleeding was the chief symptom in all patients. The mean age was 32 years old (range 21-54 ). The median duration of symptoms was 10 years (range 1month-50 years). The level of hemoglobin at admission ranged from 59.0 to 148.0g/L (mean 106.6 g/L), and the level of MCV ranged from 75.1 fl to 93.5 fl (mean 83.7 fl). Colonoscopy, CT and MRI were important in the diagnosis of DCHR because of their high positive rates and accurate features. All of the lesions are between the anal tube and the descending colon. Two patients could be found enlarged serpentine vessel in other tissues and organs. After admission, all the patients underwent TaTME and four patients had simultaneous loop ileostomy. The mean operative time was 278min (range 168-400 min). The median amount of intraoperative blood loss was 50 ml (range 10-300 ml). The mean distance from anal verge to anastomosis 2.2±0.2 cm. The anastomosis was fashioned with a stapler in two patients (28.6%). There were no intraoperative and postoperative complication happened. All the patients continued to recover well from the surgery, and nobody needed postoperative blood transfusion.

Conclusions: The definite diagnosis rate of DCHR is low. Preoperative MRI and CT examination can make a definitely diagnosis and determine the extent of the lesions. DCHR mostly restricts to the rectum, sigmoid colon, anal wall and mesorectum. The best treatment for DCHR is completely lesions resection. It is safety and feasibility to therapy DCHR by TaTME. Moreover, transanal procedure (TaTME) might have huge potential in other rectal diseases.


Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 94927

Program Number: P305

Presentation Session: Poster Session (Non CME)

Presentation Type: Poster

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