1. bookVolume 26 (2020): Issue 2 (May 2020)
Journal Details
License
Format
Journal
First Published
16 Feb 2013
Publication timeframe
4 times per year
Languages
English
access type Open Access

Multivisceral Resection of Advanced Sigmoid Colon Cancer

Published Online: 01 Jul 2021
Page range: 95 - 99
Journal Details
License
Format
Journal
First Published
16 Feb 2013
Publication timeframe
4 times per year
Languages
English
Abstract

Introduction: Colorectal cancer is one of the most common digestive malignancies, with a high mortality and morbidity rate, with nonspecific symptoms in the early stages and with a diagnosis in the advanced stage most often. In a significant percentage there are cases in which tumors with invasion in the border organs and multiorgan resections are required. In women, the invasion frequently occurs in the vagina, uterus and bladder.

Case report: We report the case of a 52-year-old woman, who presented in the Department of Surgery with the following complaints: fecaluria, pneumaturia, constipation and moderate abdominal pain, with onset of 4 months, in wich the patient neglected her symptoms. Following the investigations, a large tumor formation of sigmoid colon was diagnosed, with invasion in the uterus and bladder, with which it communicates through a 16mm fistula. The result of the biopsy was of low / moderate grade adenocarcinoma differentiated G2. Cystoscopy revealed bladder trigone invasion without being able to identify ureteral orifices, biopsy and urine cytology was also positive for cancer. The surgery was performed by a multidisciplinary team and a multivisceral resection was performed.

Conclusions: Multiorgan resections require trained, experienced teams, and oncological pathology raises special issues when it comes to radical visa. The management of invasive colonic tumors in the border organs must be established preoperatively, in agreement with the patient, because it involves problems related to the quality of life and the potential for survival.

Keywords

1. Parkin DM, Bray F, Ferlay J, Pisani P. Global Cancer Statistics, 2002. CA Cancer J Clin. 2005;55(2):74–108. Search in Google Scholar

2. Gebhardt C, Meyer W, Ruckriegel S, Meier U. Multivisceral resection of advanced colorectal carcinoma. Langenbeck’s Arch Surg. 1999;384(2):194–9. Search in Google Scholar

3. Kobayashi T, Kamoto T, Sugino Y, Takeuchi H, Habuchi T, Ogawa O. High incidence of urinary bladder involvement in carcinomas of the sigmoid and rectum: a retrospective review of 580 patients with colorectal carcinoma. J Surg Oncol. 2003 Dec;84(4):209–14. Search in Google Scholar

4. Walker KG, Anderson JH, Iskander N, McKee RF, Finlay IG. Colonic resection for colovesical fistula: 5-year follow-up. Color Dis Off J Assoc Coloproctology Gt Britain Irel. 2002 Jul;4(4):270–4. Search in Google Scholar

5. Lehnert T, Methner M, Pollok A, Schaible A, Hinz U, Herfarth C. Multivisceral resection for locally advanced primary colon and rectal cancer: an analysis of prognostic factors in 201 patients. Ann Surg. 2002 Feb;235(2):217–25. Search in Google Scholar

6. Tomizawa K, Miura Y, Fukui Y, Hanaoka Y, Toda S, Moriyama J, et al. Curative resection for locally advanced sigmoid colon cancer using neoadjuvant chemotherapy with FOLFOX plus panitumumab: A case report. Int J Surg Case Rep. 2017;31:128–31. Search in Google Scholar

7. Nerli RB, Ghagane SC, Ram P, Shimikore SS, Vinchurkar K, Hiremath MB. Bladder Invasion in Patients with Advanced Colorectal Carcinoma. Indian J Surg Oncol. 2018 Dec;9(4):547–51. Search in Google Scholar

8. Vasilevsky C-A, Belliveau P, Trudel JL, Stein BL, Gordon PH. Fistulas complicating diverticulitis. Int J Colorectal Dis. 1998;13(2):57–60. Search in Google Scholar

9. Lin C-C, Lin C-C, Chen W-S, Lin T-C, Lin J-K, Jiang J-K. Metastatic Malignancy to the Colon and Rectum: A Report of 14 Cases from One Single Institute. Dig Surg. 2018;35(3):261–5. Search in Google Scholar

10. Carne PWG, Frye JNR, Kennedy-Smith A, Keating J, Merrie A, Dennett E, et al. Local invasion of the bladder with colorectal cancers: surgical management and patterns of local recurrence. Dis Colon Rectum. 2004 Jan;47(1):44–7. Search in Google Scholar

11. Edge SB, Compton CC. The American Joint Committee on Cancer: the 7th edition of the AJCC cancer staging manual and the future of TNM. Vol. 17, Annals of surgical oncology. United States; 2010. p. 1471–4. Search in Google Scholar

12. Delacroix SEJ, Winters JC. Bladder Reconstruction and Diversion during Colorectal Surgery. Clin Colon Rectal Surg. 2010 Jun;23(2):113–8. Search in Google Scholar

13. Nelson H, Petrelli N, Carlin A, Couture J, Fleshman J, Guillem J, et al. Guidelines 2000 for Colon and Rectal Cancer Surgery. JNCI J Natl Cancer Inst. 2001;93(8):583–96. Search in Google Scholar

14. Cukier M, Smith AJ, Milot L, Chu W, Chung H, Fenech D, et al. Neoadjuvant chemoradiotherapy and multivisceral resection for primary locally advanced adherent colon cancer: a single institution experience. Eur J Surg Oncol J Eur Soc Surg Oncol Br Assoc Surg Oncol. 2012 Aug;38(8):677–82. Search in Google Scholar

15. Degener S, Brandt AS, Lazica DA, von Rundstedt F-C, Mathers MJ, Roth S. [Imperative cystectomy in patients at risk. Ileal conduit or ureterocutaneostomy?]. Urologe A. 2012 Sep;51(9):1220–7. Search in Google Scholar

16. Kotb AF. Ileal conduit post radical cystectomy: modifications of the technique. Ecancermedicalscience. 2013;7:301. Search in Google Scholar

17. Lowrance WT, Rumohr JA, Clark PE, Chang SS, Smith JAJ, Cookson MS. Urinary diversion trends at a high volume, single American tertiary care center. J Urol. 2009 Nov;182(5):2369–74. Search in Google Scholar

18. Winter DC, Walsh R, Lee G, Kiely D, O’Riordain MG, O’Sullivan GC. Local involvement of the urinary bladder in primary colorectal cancer: outcome with en bloc resection. Ann Surg Oncol. 2007 Feb;14(2):441–6. Search in Google Scholar

Recommended articles from Trend MD

Plan your remote conference with Sciendo