Woman cured of cancer through unique surgery

MANGALORE: The department of gastroenterology at KMC Hospital, Jyothi Circle has cured a 55-year old woman who had bleeding in her rectum. She was evaluated by senior consultant gastroenterologist B V Tantry, who diagnosed it as cancer of the lower rectum and referred the case to Vijay Ramachandran, surgical gastroenterologist and colorectal surgeon.The tumour was located exactly 4 cm from the anus.
Usually, resection of such tumours would require the patient to agree to a permanent colostomy as it would be very difficult to join the remaining colon to the anal canal. The practical difficulties with a colostomy include the stigma associated with it, bad odour and need to empty faecal matter at regular intervals. Dr Vijay performed a procedure known as ultra-low anterior resection, Colonic J Pouch anal anastomosis.
Here, the tumour was resected with a 2 cm distal margin; a pouch was fashioned out of the descending colon and joined to the anal canal. The patient also underwent a total abdominal hysterectomy in the same sitting. The advantage of this procedure was that the patient was spared of colostomy. Moreover, the Colonic J Pouch ensured that the function of the rectum, that is, storage of faecal matter, was taken over by the pouch fashioned out of the descending colon.
Dr Vijay stated that the procedure ensured adherence to principles of cancer surgery, avoided a colostomy and ensured a near-normal lifestyle in a select subset of patients.