A Case of Abdominoperineal Resection with Prostatectomy for Lower Rectal Cancer Infiltrating into the Prostate

Abstract

A 58-year-old man with bloody stool diagnosed with lower rectal cancer by a local physician and referred to our hospital was found to have a hemicircumferential type 2 lesion mainly located in the anterior wall of the rectum. The lower edge of the tumor was 2cm above the dentate line. Computed tomography, magnetic resonance imaging, and endoscopic ultrasonography suggested infiltration into the left side of the prostate. Because no distant metastases were found preoperative preoperatively, we conducted curative abdominoperineal resection, prostatectomy, and lateral lymph node dissection, pathologically confirming infiltration into the prostate and a negative surgical margin, especially toward the left pelvic wall. Dehiscence of the vesicourethral anastomosis had occurred but improved with conservative treatment. Although the left pelvicnerve plexus was resected, bladder function was preserved. We reported this complicated but beneficial procedure for lower rectal cancer infiltration only into the prostate, which ensures negative surgical margin and obviates the need for total pelvic exenteration.