Koike Naoto, Ohshima Yuji, Takeuchi Toshiaki, Arita Seiji, Shinozaki Eiji
Dept. of Surgery, Seirei Sakura Citizen Hospital, Japan.
Gan To Kagaku Ryoho. 2013 Jun;40(6):815-7.
We report a case of advanced rectal cancer treated with chemotherapy, for which laparoscopic splenectomy had been effective for thrombocytopenia. A 56-year-old man suffered from advanced rectal cancer with multiple lung metastases. He underwent Hartmann's procedure and received chemotherapy with FOLFOX and FOLFIRI with bevacizumab. After 3 years and 2 months, he also suffered from splenomegaly and thrombocytopenia. Laparoscopic splenectomy produced and increased the thrombocyte count, allowing for a restart of chemotherapy. Oxaliplatin-based chemotherapy might produce hepatic sinusoid injury and induce splenomegaly owing to portal hypertension. Laparoscopic splenectomy seemed to be useful for treating thrombocytopenia, and allowed the continuation of chemotherapy.
我们报告一例接受化疗的晚期直肠癌病例,对于该病例,腹腔镜脾切除术对血小板减少症有效。一名56岁男性患有伴有多处肺转移的晚期直肠癌。他接受了哈特曼手术,并接受了含奥沙利铂和亚叶酸钙的氟尿嘧啶、亚叶酸钙、伊立替康联合贝伐单抗化疗。3年零2个月后,他还出现了脾肿大和血小板减少症。腹腔镜脾切除术使血小板计数增加,从而得以重新开始化疗。基于奥沙利铂的化疗可能会导致肝血窦损伤,并由于门静脉高压引起脾肿大。腹腔镜脾切除术似乎对治疗血小板减少症有用,并能使化疗得以继续进行。