Repeated Anastomotic Recurrence After Right Hemicolectomy: A Rare Therapeutic Challenge

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ID: 311603
2025
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Abstract
Anastomotic recurrence after curative resection of colorectal cancer represents a rare but clinically significant phenomenon, occurring in approximately 2% of operated patients. We present a case report of a 61-year-old male patient who developed two successive anastomotic recurrences after right hemicolectomy with ileocolic anastomosis for mucinous adenocarcinoma. The patient initially underwent right hemicolectomy in 2016 for T4b, N2b, M0 mucinous adenocarcinoma with clear surgical margins. Following completion of adjuvant chemotherapy, the first anastomotic recurrence occurred in January 2019 (36 months postoperatively), treated by ileocolic resection with ileocolic anastomosis. The second recurrence occurred in March 2020 (14 months after the first recurrence), managed by total colectomy with ileorectal anastomosis. Pathological examination confirmed recurrence with characteristics similar to the primary tumor in both instances. At 3 months follow-up after the final intervention, no additional recurrence was observed. Repeated anastomotic recurrence represents a rare therapeutic challenge requiring intensive surveillance, a multidisciplinary approach, and escalating surgical management. Understanding pathophysiological mechanisms, including the role of the anastomotic microenvironment and tumor biology, is important for developing preventive strategies in highrisk patients.
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Authors Rabti Souphia, Ben Hassine Basma, Wael Ferjaoui, Ben Marzouk Sawssen, Lassad Gharbi, Saadia Bouraoui, Dhouha Bacha
Journal Yemen Journal of Medicine
Year 2025
DOI
10.63475/yjm.v4i3.0219
URL
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