Rektal Kanserli Hastada Bevacizumab Tedavisi Sonrası Gecikmiş Anastomoz Kaçağı: Olgu Sunumu

Öz

Kolorektal kanser (KRK) tedavisinde cerrahi, kemoterapi ve hedefe yönelik ajanlar önemli rol oynar. Bevacizumab, metastatik KRK’de kullanılan bir VEGF inhibitörüdür ancak yara iyileşmesini geciktirerek anastomoz kaçağı riskini artırabilir. Bu olguda, rektum kanseri nedeniyle düşük anterior rezeksiyon yapılan 71 yaşındaki bir hastada, ameliyattan 26 ay sonra gecikmiş anastomoz kaçağı gelişmiştir. Görüntülemelerde presakral apse ve bağırsak lümeni ile bağlantılı koleksiyon saptanmış, cerrahi eksplorasyonda anastomoz ayrışması görülmüştür. Hastaya saptırıcı kolostomi açılmış ve postoperatif dönemde stabil seyretmiştir. Bu vaka, bevacizumab tedavisinin geç dönemde bile anastomoz bütünlüğünü etkileyebileceğini göstermekte ve bu hastaların uzun süreli dikkatli takibinin gerekliliğini vurgulamaktadır.

Anahtar Kelimeler

• Kolorektal kanser
• anastomoz kaçağı
• bevacizumab

Delayed Anastomotic Leakage After Bevacizumab Therapy in rectal Cancer Patient: A Case Report

Öz

Surgery, chemotherapy, and targeted agents play crucial roles in the treatment of colorectal cancer (CRC). Bevacizumab, a vascular endothelial growth factor (VEGF) inhibitor used in metastatic CRC, has been associated with delayed wound healing, potentially increasing the risk of anastomotic leakage. In this case, a 71-year-old patient who underwent low anterior resection for rectal cancer developed delayed anastomotic leakage 26 months after surgery. Imaging revealed a presacral abscess and a collection communicating with the intestinal lumen, and surgical exploration confirmed anastomotic dehiscence. A diverting colostomy was performed, and the patient remained stable in the postoperative period. This case highlights that bevacizumab therapy can impact anastomotic integrity even in the late postoperative period, emphasizing the need for prolonged and careful follow-up in such patients.

Anahtar Kelimeler

• Colorectal cancer
• anastomotic leak
• bevacizumab

Kaynakça

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