A Case of Anastomotic Recurrence 6 Years and 7 Months after Functional End-to-End Anastomosis Performed for Transverse Colon Cancer

Abstract

The patient was a 79-year-old female who underwent laparoscopic left hemicolectomy and D3 dissection with functional end-to-end anastomosis (FEEA) for transverse colon cancer. It was histopathologically diagnosed as moderately differentiated adenocarcinoma, T3 (SS), N1, M0, stage IIIa, according to the Japanese Classification of Colorectal, Appendiceal, and Anal Carcinoma, 8th edition. Nine months later, liver metastasis appeared and partial hepatectomy was performed. One year later, lung metastasis appeared and partial pulmonary resection was performed. Six years later, anticoagulant therapy was started because of DVT. Six years and 7 months later, she developed bloody stool and anemia; colonoscopy revealed recurrence of anastomotic type 3 tumor along the staple line, and biopsy revealed moderately differentiated adenocarcinoma, necessitating laparoscopic partial colon resection involving the anastomotic region. Pathological examination showed a similar histological type and tumor development from the staple, suggesting implantation metastasis. No relapse has been reported for 14 months after the operation. It is important to establish more effective measures for FEEA which has a high rate of anastomotic recurrence.