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Erschienen in:
25.05.2020 | The Last Image
Colostomy site recurrence in rectal cancer
Erschienen in: Techniques in Coloproctology | Ausgabe 10/2020
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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. 1
Large ulcerated stomal recurrence
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. 3
The line marking of the subcutaneous pedicled tensor-fascia-lata 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
Fig. 4
Skin island flap is raised in the subfascial plane
Fig. 5
The flap is placed in the abdominal wall defect. The tensor-fascia-lata of the flap is sutured to the rectus anterior rectus sheath medially and oblique muscles laterally
Fig. 6
Postoperative image
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