Total Pelvic Exenteration and Neobladder Reconstruction with Modified Studer's Procedure for Invasive Rectal Carcionoma.: A Case Report

Abstract

Total pelvic exenteration (TPE) generally requires the construction of double stomas after surgery, dramatically and adversely affecting the patient's quality of life (QOL). Stoma-free TPE for invasive rectal cancer has been reported with good prognosis and improved QOL. A 61-year-old man with constipation was found in total colonoscopy to have an ulcerative tumor in the lower rectum, and biopsy revealed moderately differentiated adenocarcinoma of the rectum. Diagnostic imaging showed that advanced rectal cancer had widely invaded the bladder. There was no evidence of metastasis to other organs. We conducted TPE with bladder reconstruction using Studer's procedure on July 9. The patient was discharged on September 30, maintaining full continence in the daytime and residual urine volumes after straining below 50ml. TPE with Studer's neobladder may thus be a viable option after curative surgery for rectal carcinoma infiltrating the bladder.