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

Yıl 2019, , 148 - 151, 01.12.2019

Malek Bouhani , Olfa Jaidane Mohamed Amine Bouida Radhi Bennaceur Riadh Chargui Khaled Rahal

https://doi.org/10.25000/acem.589711

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

Öz

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. 

Anahtar Kelimeler

rectal cancer, recurrence, colostomy, reconstructive surgical procedures.

Kaynakça

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