Treatment of side limb full-thickness prolapse of the side-to-end coloanal anastomosis follow-ing intersphincteric resection: a case report and review of literature

• Published in: Annals of coloproctology
• Main Authors: Piozzi, Guglielmo Niccolò, Khobragade, Krunal, Shin, Seon Hui, Choo, Jeong Min, Kim, Seon Hahn
• Format: Journal Article
• Language: English
• Published: Korea (South) 08.02.2023
• Subjects: Intersphincteric resection, Rectal neoplasms, Rectal prolapse, Coloanal anas-tomosis, Robotic surgical procedures
• ISSN: 2287-9714

Intersphincteric resection (ISR) with coloanal anastomosis is an oncologically safe anus-preserving technique for very low-lying rectal cancers. Most studies focused on oncological and functional outcomes of ISR with very few evaluating long-term postoperative anorectal complications. Full-thickness prolapse of the neorectum is a relatively rare complication. This report presents the case of a 70-year-old woman presenting with full-thickness prolapse of the side limb of the side-to-end coloanal anastomosis occurring 2 weeks after the stoma closure and 2 months after a robotic partial ISR performed with the Da Vinci single-port platform (Intuitive Surgical System Inc.). The anastomosis was revised through resection of the side limb and conversion of the side-to-end anastomosis into an end-to-end handsewn anastomosis with interrupted stitches. This study describes the first case of full-thickness prolapse of the side limb of the side-to-end handsewn coloanal anastomosis following ISR. Moreover, a revision of all reported cases of post-ISR full-thickness and mucosal prolapse was performed.