Diseases of the Colon & Rectum

, Volume 42, Issue 8, pp 1097–1101 | Cite as

Total anorectal and partial vaginal reconstruction with dynamic graciloplasty and colonic vaginoplasty after extended abdominoperineal resection

Report of a case
  • Eric Rullier
  • Tarun McBride
  • Frank Zerbib
  • Michel Caudry
  • Jean Saric
Case Reports
  • 24 Downloads

Abstract

PURPOSE: Quality of life is altered after abdominoperineal resection, because of permanent iliac colostomy. Psychological rehabilitation is even more difficult after extended abdominoperineal resection to the vagina, because of the loss of both continence and sexual functions. We report the first case of total anorectal and vaginal reconstruction using dynamic graciloplasty and colonic vaginoplasty after extended abdominoperineal resection. METHODS: A 46-year-old female underwent extended abdominoperineal resection with posterior colpectomy for a low rectal adenocarcinoma infiltrating the anal sphincter and vagina. Anorectal reconstruction was performed with coloperineal anastomosis and double dynamic graciloplasty. Vaginal reconstruction was performed using a 10-cm, isolated, rotated sigmoid loop. The procedure was performed in three stages, including abdominoperineal resection with reconstruction, implantation of the stimulator, and closure of the temporary ileostomy. RESULTS: Resting and electrostimulated pressures of the neosphincter were 40 and 110 cm H2O respectively. Continence was achieved for formed stools two months after closure of the stoma, with spontaneous defecations (30–90 minutes). The patient experienced regular sexual activity six months after closure of the stoma. CONCLUSION: This new original technique can be proposed in selected young females after extended abdominoperineal resection, to preserve continence, sexual activity, and body image.

Key words

Dynamic graciloplasty Colonic vaginoplasty Abdominoperineal resection Rectal cancer 

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Copyright information

© The American Society of Colon and Rectal Surgeons 1999

Authors and Affiliations

  • Eric Rullier
    • 3
  • Tarun McBride
    • 3
  • Frank Zerbib
    • 1
  • Michel Caudry
    • 2
  • Jean Saric
    • 3
  1. 1.the Department of GastroenterologySaint-Andre HospitalBordeauxFrance
  2. 2.the Department of RadiotherapySaint-Andre HospitalBordeauxFrance
  3. 3.Department of SurgerySaint-Andre HospitalBordeauxFrance

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