tannins and Rectal-Neoplasms

We herein report the first case of rectal stenosis that developed after internal hemorrhoid treatment with aluminum potassium sulfate and tannic acid (ALTA) therapy that was successfully treated by laparoscopic surgery. A 72-year-old man suffered from a fever and rectal stenosis after undergoing internal hemorrhoid treatment with a submucosal injection of ALTA at a previous clinic. Three months after ALTA therapy, he developed frequent mucous and bloody stools. Lower intestinal tract endoscopy revealed circumferential severe rectal stenosis. He was therefore referred to our hospital. The patient suffered from frequent stool build-up and difficulty defecating. We performed balloon-dilatation intervention. The stenosis was not improved at all. Five months after ALTA therapy, we performed laparoscopic low anterior resection with diverting ileostomy. Three months after the operation, ileostomy takedown was performed. The patient has experienced no rectal stenosis in the 2 years since his radical operation.

Topics: Aged; Constriction, Pathologic; Hemorrhoids; Humans; Laparoscopy; Male; Rectal Neoplasms; Sclerosing Solutions; Tannins

Aluminum potassium sulfate and tannic acid (ALTA) injection is a new sclerosing therapy for internal hemorrhoids that has been gaining widespread use. However, there have been few reports about rectal cancer after ALTA injection. We performed laparoscopic surgery for three patients who had underwent ALTA therapy 6 months or 1 year earlier: (i) a 51-year-old man with neuroendocrine tumor; (ii) a 44-year-old woman with rectal cancer; and (iii) 77-year-old man with rectal cancer. All three patients had sclerosis of the resected rectal wall stump, making transection of the rectum difficult. Histological examination of the specimens also showed an inflammatory reaction and/or fibrosis of the resection stump. Although laparoscopic low anterior resection was planned for all three patients, we had to construct a diverting stoma for two patients and could not perform sphincter-preserving surgery for the other. We must be well prepared for laparoscopic rectal surgeries after ALTA therapy, and these cases suggest sigmoidoscopy before ALTA therapy should be recommended.

Topics: Adult; Aged; Alum Compounds; Female; Hemorrhoids; Humans; Laparoscopy; Male; Middle Aged; Rectal Neoplasms; Sclerosing Solutions; Tannins

We report a case of laparoscopic surgery for a rectal carcinoid after aluminum potassium and tannic acid (ALTA) therapy for an internal hemorrhoid. A 66-year-old man was admitted to our hospital because of bleeding during defecation. He was diagnosed via anoscopy with Goligher grade II internal hemorrhoids. Examination via colonoscopy revealed 2 yellowish submucosal tumors in the lower rectum that were 5mm and 10mm in diameter. A rectal carcinoid tumor was diagnosed based on histopathology. Abdominal computed tomography demonstrated no metastases to the liver or lymph nodes. First, we performed ALTA therapy for the internal hemorrhoids. Two weeks later, we performed laparoscopic-assisted low anterior resection (D2) for the rectal carcinoid. The patient was discharged without complications and has not experienced recurrence during the 2 years of follow-up care.

Topics: Aged; Alum Compounds; Carcinoid Tumor; Combined Modality Therapy; Hemorrhoids; Humans; Intestinal Neoplasms; Male; Rectal Neoplasms; Tannins; Treatment Outcome

Topics: Adenocarcinoma; Breast Neoplasms; Colonic Neoplasms; Humans; Intestinal Neoplasms; Kidney Neoplasms; Lung Neoplasms; Microscopy, Electron; Molybdenum; Phosphorus; Rectal Neoplasms; Staining and Labeling; Tannins; Thyroid Neoplasms

Topics: Barium Sulfate; Colonic Neoplasms; Contrast Media; Enema; Humans; Methods; Radiography; Rectal Neoplasms; Tannins; Technology, Radiologic