Title:
Specific Features of Proctectomy in a Pelvis Presenting Anatomical Variation Type: Bilateral Kidney Ectopia.

Authors:
N. Chadli, M E A. Meghaizerou, R. Djaid, M N E. Bouhafs, A. Menasria, A. Remini, A. Benslimane, A. Belkadi, N E. Tahlaiti, H. Abdelmounaim, K. Fasla, A. Bengueddache, O.Tilioua, M. Habarek, Algeria

Abstract:

A 66-year-old woman with hypertension was admitted for the management of a moderately differentiated adenocarcinoma (ADK) of the mid and lower rectum, revealed by chronic constipation lasting over a year. Additional examinations identified a tumor in the mid and lower rectum, classified as cT3NxM0, with an abnormal anatomical positioning of both kidneys in a pelvic location. Following discussion in a multidisciplinary team meeting, the patient underwent chemotherapy (CT) alone, followed by a laparoscopic proctectomy with total mesorectal excision (TME), preserving both kidneys and their vascularization. This article aims to highlight the importance of understanding the anatomical relationships between the rectum and pelvic kidneys, the potential pitfalls to avoid during pre and intraoperative management, and the value of a multidisciplinary approach.

DOI: http://dx.doi.org/10.51505/ijmshr.2025.9302