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59588 Surgery

A 55-year-old man was referred to surgeon because he has become increasingly constipated over the last 2 months. This has occurred despite attempts to increase fiber in his diet and to markedly increase his physical activity. Laxatives have been mostly ineffective. On fuher questioning, the man repos that he has twice seen fresh blood on his stools, which he attributed to hemorrhoids. He has also noticed a sense of fullness and discomfo in his lower left abdominal quadrant, but attributed these findings to his constipation. Digital examination is negative. Colonoscopy demonstrates an area of stricture with surface ulceration 10 cm above the anal verge. The distal colon is surgically resected. Pathologic examination demonstrates a napkin-ring lesion with marked thickening of the mucosal layer of the rectum. On cross- section, the lesion is seen to extend through the rectal muscle and into, but not through, the adjacent serosal adipose tissue. Fuher evaluation fails to demonstrate the patient’s disease in either lymph nodes or distant sites. This patient’s disease would be staged as which of the following?

ADuke's classification A
BDuke's classification B1
CDuke's classification B2
DDuke's classification C1
Surgery
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