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一名患有结直肠肝转移且正在接受化疗和贝伐单抗治疗的患者,采用生物补片进行急诊开放性嵌顿疝修补术,伤口愈合顺利。

Emergency open incarcerated hernia repair with a biological mesh in a patient with colorectal liver metastasis receiving chemotherapy and bevacizumab uncomplicated wound healing.

作者信息

Giakoustidis Alexandros, Morrison Dawn, Neofytou Kyriakos, Giakoustidis Dimitrios, Mudan Satvinder

机构信息

Department of Surgery, The London Clinic, 20 Devonshire Pl, London W1G 6BW, UK.

Upper GI/HPB Unit, Department of Academic Surgery, Royal Marsden Hospital, Fulham Roadd, London SW3 6JJ, UK.

出版信息

Case Rep Emerg Med. 2014;2014:848030. doi: 10.1155/2014/848030. Epub 2014 Dec 21.

Abstract

Bevacizumab is a humanized monoclonal antibody targeting vascular endothelial growth factor (VEGF), often used in combinational chemotherapy regimens for the treatment of patients with colorectal liver metastases. However adverse events have been attributed to the use of bevacizumab including gastrointestinal perforations, thrombotic events, hypertension, bleeding, and wound healing complications. 53-year-old male, with a history of colorectal cancer with liver metastasis, receiving a combination of cytotoxic chemotherapy (FOLFIRI, irinotecan with fluorouracil and folinic acid) with bevacizumab presented as an emergency with an incarcerated incisional hernia. The last administration of chemotherapy and bevacizumab had taken place 2 weeks prior to this presentation. As the risk of strangulation of the bowel was increased, a decision was made to take the patient to theatre, although the hazard with respect to wound healing, haemorrhage, and infection risk was high due to the recent administration of chemotherapy with bevacizumab. The patient underwent an open repair of the incarcerated recurrent incisional hernia with placement of a biological mesh, and the postoperative recovery was uncomplicated with no wound healing or bleeding problems.

摘要

贝伐单抗是一种靶向血管内皮生长因子(VEGF)的人源化单克隆抗体,常用于联合化疗方案治疗结直肠癌肝转移患者。然而,使用贝伐单抗会引发不良事件,包括胃肠道穿孔、血栓形成事件、高血压、出血和伤口愈合并发症。一名53岁男性,有结直肠癌伴肝转移病史,接受细胞毒性化疗(FOLFIRI,伊立替康联合氟尿嘧啶和亚叶酸)与贝伐单抗联合治疗,因嵌顿性切口疝作为急诊入院。此次就诊前2周进行了最后一次化疗和贝伐单抗治疗。由于肠绞窄风险增加,尽管近期使用化疗和贝伐单抗导致伤口愈合、出血和感染风险较高,但仍决定将患者送往手术室。患者接受了嵌顿性复发性切口疝的开放修复并放置生物补片,术后恢复顺利,无伤口愈合或出血问题。

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