Inferior region of natal cleft is adjecent with anal verge
and perianal region with internal and external sphincteric muscle which have deep extention.
The patient in our case clearly had a rectal cancer by accepted definitions and would have been a candidate for neoadjuvant radiation therapy based on the distance of the distal tumor margin to the anal verge
but also demonstrated seeding of the peritoneal cavity likely due to anterior growth of the tumor and involvement of the intraperitoneal segment of the rectum.
The demographic and preoperative characteristics did not differ between the two groups except for the tumor location from the anal verge
In our study, there was no significant difference between the robotic and laparoscopic groups in terms of age, gender, BMI, ASA, distance from the anal verge
, preoperative clinical stage, and rate of upfront chemoradiation.
Endoscopy revealed a mucosal ulcer in the distal part of the rectum 10 cm from the anal verge
. The lesion was cauterized, injected with epinephrine, and suture-ligated.
Rectal cancer was defined as a tumor located within 15 cm of the anal verge
. The distal resection margin was defined as the distance from the lowest border of the tumor to the distal mucosal end of the fixed specimen.
Anal margin lesions refer to tumors starting at the distal end of the anal canal to a 5cm margin surrounding the anal verge
. The staging of anal marginal cancers by the American joint committee is as follows: T1 if the tumor is less than 2 cm in size T2 if it is 2-5 cm T3 if it is greater than 5 cm and T4 signifies invasion of deep extradermal structures such as bone nerve striated muscle or cartilage.
The risk varies with the site of the anastomosis with those placed less than 5 centimeters (cm) from the anal verge
being particularly vulnerable .
Clinically he was suspected to have rectal growth and was subjected to sigmoidoscopy, which showed the presence of a rectal mass just above the anal verge
. The sigmoidoscopic (Figure 1) impression was that of a rectal carcinoma.
There were venous varicosities at the junction of normal and ulcerated mucosa 40cm from the anal verge
. Rest of the colonic mucosa was normal up to cecum.
Exam revealed a rectal mass 7 cm from the anal verge
. Colonoscopy and biopsy confirmed a 4 cm moderately differentiated adenocarcinoma.
In rupture of the bulb of the urethra - classically in a fall with legs apart across a fence - blood and urine extravasate into the scrotum, track up into the lower abdominal wall, but the fluid remains trapped in front of the anal verge