A 70-year-old man is found to have distal rectal cancer during a screening colonoscopy. The patient undergoes preoperative staging and is found to have a 1.5-cm rectal mass that does not invade the muscularis propria of the rectal wall. There is no regional lymphadenopathy and no evidence of distant metastases. The patient is staged at T1N0M0. The patient is advised to undergo APR but refuses because it will lead to anal sphincter loss and permanent colostomy. Which of the following represents a viable alternate therapeutic option for this patient?

Question

Quizplus · Accepted Answer

For a T1N0M0 rectal cancer that does not invade beyond the muscularis propria and with no evidence of regional lymphadenopathy or distant metastases, a less invasive option like full-thickness surgical removal of the tumor (transanal excision) can be considered. This approach can preserve the anal sphincter and avoid the need for a permanent colostomy, making it a viable alternative for patients refusing more radical surgery like abdominoperineal resection (APR).

A 70-Year-Old Man Is Found to Have Distal Rectal Cancer