Curative resection performed twice for circular-staple-line recurrence after colorectal carcinoma surgery: report of a case.

Staple-line recurrence is an important pattern of recurrence after colorectal carcinoma surgery, occurring in approximately 1% of patients. We report the case of a 44-year-old woman who underwent resection of carcinoma recurrence in a circular-staple-line twice within 34 months. Initially, she underwent sigmoidectomy for carcinoma of the sigmoid colon, followed by end-to-end anastomosis, done using a circular stapler. Subsequently, she underwent an anterior resection, then a low anterior resection, 12 and 34 months after the initial operation, respectively, both to treat a circular-staple-line recurrence of the tumor. Histological examination of all resected specimens revealed moderately differentiated adenocarcinoma with clear surgical margins and no lymph node metastasis. The patient remains well with no evidence of disease 48 months after her initial operation. To our knowledge, this is the first reported case of curative surgical resection being performed twice for circular-staple-line recurrence of colorectal carcinoma. Based on our experience and our review of the literature, early detection by follow-up colonoscopy and surgical resection may improve the prognosis of patients with a staple-line recurrence after the resection of colorectal carcinoma.