Perineal psödo-kontinan kolostomi üzerinde alt rektal karsinom rekürrensinin başarılı tedavisi: Bir olgu sunumu ve literatürün gözden geçirilmesi

Öz

Perineal psödo-kontinan kolostomi üzerinde alt rektal karsinomun rekürrensi literatürde nadiren bildirilmektedir ve hekimler için gerçek bir zor durum oluşturmaktadır. Bu çalışmada, rektum kanserinde nadir bir rekürrens ve yönetimi sunulmuştur.

56 yaşında bir erkek hasta alt rektum yerleşimli evre II adenokarsinom ile başvurdu. Eş zamanlı kemoradyoterapi ve ardından perineal psödo-kontinan kolostomi ile abdominoperineal rezeksiyon yapıldı. Üç yıl sonra, perineal psödo-kontinan kolostomi üzerinde önceki adenokarsinomunun lokal rekürrensi gelişti. Hastaya geniş eksizyon uygulandı, ardından rektus abdominis miyokutan flebi ile inferior pedikül ve oblik cilt adasıyla rekonstrüksiyon yapıldı. Hasta adjuvan kemoterapi aldı. Hasta 3 yıllık takip süresinde hastalıksız olarak izlenmektedir.

Genişletilmiş bir rezeksiyon, lokal rekürren rektum kanseri için ilk ​​tedavi olarak düşünülmelidir.

Anahtar Kelimeler

• rektal kanser,rekürrens,kolostomi,rekonstruktif cerrahi işlemler

Successful management of lower rectal carcinoma recurrence on perineal pseudo-continent colostomy: a case report and review of literature

Abstract

Recurrence of lower rectal carcinoma on perineal pseudo-continent colostomy is rarely reported in the literature. It presents a real challenge for the physician. The aim of this case report was to document an exceptional recurrence and how to manage it. 

A 56-year-old man presented with stage II adenocarcinoma of the lower rectum. He received concomitant chemoradiation followed by abdominoperineal resection with perineal pseudo-continent colostomy. Three years later, he developed a local recurrence of his prior adenocarcinoma, on the perineal pseudo-continent colostomy. He underwent wide excision, followed by reconstruction with a rectus abdominis myocutaneous flap with an inferior pedicle and an oblique skin paddle. He underwent adjuvant chemotherapy. The patient is free of disease with three years follow up.

Extended resection should be considered as an initial treatment for locally recurrent rectal cancer. 

Keywords

• rectal cancer,recurrence,colostomy,reconstructive surgical procedures.

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