Experience of transanal endoscopic microsurgery in the treatment of synchronous primary multiple colorectal cancer: a case report

INTRODUCTION: The incidence of primary multiple colorectal cancer ranges from 1% to 8%. In 50% of cases, synchronous malignant tumors are located in different segments of the colon, which requires expanding the scope of the operation to colectomy, colproctectomy or simultaneous resections of different segments of the colon. The article presents a clinical case of a 65-year-old patient with rare and difficult to diagnose synchronous primary multiple colorectal cancer. Simultaneous laparoscopic right hemicolectomy with D2 lymphadenectomy and transanal endoscopic excision of the rectal tumor were performed in the treatment. As a result, it was possible to avoid low anterior resection of the rectum with a ‘switching-off’ stoma, achieve the fastest possible rehabilitation and the absence of complications in the postoperative period. It is worth noting, however, that the transanal stage took 90 minutes with relatively small tumor sizes, which is associated with the stage of mastering the technique and overcoming the learning curve. CONCLUSION: Transanal endomicrosurgery is an effective and safe option for surgical treatment of rectal tumors.