CASE REPORT   

Chirurgia 2020 June;33(3):160-3

DOI: 10.23736/S0394-9508.19.04981-7

Copyright © 2019 EDIZIONI MINERVA MEDICA

lingua: Inglese

Consecutive multiple organ resections for locally advanced colon cancer

Razvan ION, Simona MURESAN ✉, Tatiana D. SALA, Dorin ZAMFIR, Ruxandra DARIE, Ionut BALMOS

University of Medicine, Pharmacy, Science and Technology, George Emil Palade of Tirgu Mures, Tirgu Mures, Romania

The colo-rectal cancer represents one of the main malignant disease of the dygestive tract. Despite the very developed treatments from the last decades, the local invasion and reccurences still represents a challenge for the radical resections and healing. We present a case of 63 man years old who undergone four consecutive surgical procedures for an advance local right colon cancer. The first surgery consisted in right hemicholectomy and partial resection of duodenum with Y Roux loop reconstruction of it. The local reccurence after 16 months required the second surgery: cephalic duodenopancreathectomy and segmental jejunotomy. A biliary fistula after the second surgery leaded to the third surgery: fistula fibrotic tube implantation into ileonum. The reccurence invading the main biliary duct imposed the fourth surgery: Invaded hepatic duct resection with Doglioti anastomosis. After 6 months from the last surgery, there are no signs of reccurences. In patients diagnosed with right colon cancer extended to pancreas and/or duodenum, multivisceral surgical resection is recommended when complete tumor extirpation (R0) is possible. The prognosis is generally good, improved by the multifactorial oncology treatment, allowing these patients to have an absolutely normal lifestyle with adequate social and professional reintegration and therefore a satisfactory quality of life in most cases.

KEY WORDS: Colonic neoplasms; Surgical procedures, operative; Prognosis