Colostomy site recurrence in rectal cancer
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Colostomy site recurrence in rectal cancer P. K. Garg1 · J. R. Kumar1 · R. Kumar1 · M. P. Singh1 Received: 21 April 2020 / Accepted: 13 May 2020 © Springer Nature Switzerland AG 2020
A 32-year-old woman, a rectal cancer survivor, presented with a large ulcerated mass over her colostomy (Fig. 1). She had undergone abdominoperineal resection for a locally advanced rectal adenocarcinoma followed by adjuvant chemotherapy 1 year before she came to our institution. The abdominal computed tomography scan showed a large ill-defined heterogeneously enhancing lesion involving the colostomy (Fig. 2). Biopsy confirmed stomal recurrence. The patient had a palliative resection of the stomal recurrence with subcutaneous pedicled tensor-fascia-lata flap reconstruction and refashioning of the stoma (Figs. 3, 4, 5, 6). Fig. 2 Axial section of the abdominal computed tomography scan shows a large ill-defined heterogeneously enhancing lesion involving the colostomy and causing its luminal attenuation
Fig. 1 Large ulcerated stomal recurrence Fig. 3 The line marking of the subcutaneous pedicled tensor-fascialata flap—the anterior border of the skin island is marked as a straight line form the anterior superior iliac spine and the posterior border of the skin island is a line extending from the greater trochanter
* P. K. Garg [email protected] 1
Department of Surgical Oncology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand 249203, India
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Fig. 4 Skin island flap is raised in the subfascial plane
Techniques in Coloproctology
Fig. 6 Postoperative image
Compliance with ethical standards Conflict of interest The authors declare that they have no conflict of interest. Ethical approval The patient was managed as per the standard guidelines and institutional treatment protocols. Informed consent Informed consent was obtained from the patient for the publication.
Publisher’s Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Fig. 5 The flap is placed in the abdominal wall defect. The tensorfascia-lata of the flap is sutured to the rectus anterior rectus sheath medially and oblique muscles laterally
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