Hamid Mohamed, Majbar Anass Mohamed, Hrora Abdelmalek, Ahallat Mohamed
Faculty of Medicine and Pharmacy of Rabat, Department of Surgery, Ibn Sina Hospital, Mohammed V University of Rabat, Rabat, Morocco.
Surg Case Rep. 2017 Dec 28;3(1):130. doi: 10.1186/s40792-017-0405-0.
Local recurrence of colorectal cancer is a major cause of morbidity and mortality that usually implies a worse prognosis. Its etiopathogenesis is still a subject of debate. Recurrence on the perineal wound caused by anal retractor device is rarely reported.
We present the case of a 75-year-old woman with perineal skin recurrence on the site of Lone Star Retractor™ from rectal adenocarcinoma. The patient underwent a curative proctectomy followed by a hand-sewn coloanal anastomosis using Lone Star Retractor™ 2 years ago for a tumor of the lower rectum. The recurrence was most likely caused by the seeding of exfoliated tumor cells into the perianal skin which was abraded by the retractor.
This case is the fourth case reported in the literature and highlights the importance of the use of less traumatic endoanal retractors to prevent such perianal recurrence. Recurrence on the perineal wound caused by anal retractor device is rare but possible. Further studies are needed to define preventive measures able to reduce cutaneous implants.
结直肠癌局部复发是发病和死亡的主要原因，通常意味着预后较差。其病因发病机制仍是一个有争议的话题。由肛门牵开器装置导致的会阴伤口复发很少被报道。
我们报告了一名75岁女性的病例，其直肠腺癌在Lone Star Retractor™部位出现会阴皮肤复发。患者2年前因低位直肠肿瘤接受了根治性直肠切除术，随后使用Lone Star Retractor™进行手工缝合结肠肛管吻合术。复发很可能是由于脱落的肿瘤细胞种植到被牵开器擦伤的肛周皮肤所致。
该病例是文献报道的第四例，强调了使用创伤较小的肛门内牵开器以预防此类肛周复发的重要性。由肛门牵开器装置引起会阴部伤口复发虽罕见但有可能。需要进一步研究以确定能够减少皮肤种植的预防措施。
