Jiang Xuetong, Xu Chuanqi, Tang Dong, Wang Daorong
Department of Gastrointestinal Surgery, Clinical Medical College of Yangzhou University, Subei People's Hospital of Jiangsu, Yangzhou, Jiangsu 225001, P.R. China.
Oncol Lett. 2016 Aug;12(2):1525-1528. doi: 10.3892/ol.2016.4803. Epub 2016 Jun 29.
Synchronous colorectal cancers refer to the simultaneous occurrence of multiple colorectal tumors in a single patient, excluding any metastases from other organs. At present, radical surgery is considered the standard curative treatment; however, individualized surgical strategies depend on tumor location, the depth of invasion and the general health of the patient. In the present study, the case of a 52-year-old man who presented with a 2-month history of abdominal pain that was accompanied by intermittent hematochezia and weight loss is reported. The patient had no family history of cancer. Computed tomography (CT) of the abdomen revealed intestinal wall thickness in the transverse colon and volvulus in the hepatic flexure of colon. Colonoscopy identified 3 tumors: The first tumor was located in the descending colon with lumen stenosis ~60 cm from the anal verge, the second tumor was located in the hepatic flexure of the colon, and the third tumor was located in the sigmoid colon, 23 cm from the anal verge. Subsequently, laparoscopic subtotal colectomy was performed and all three tumors were removed, and the diagnosis was confirmed by histopathological examination. The patient did not undergo chemotherapy following surgery, due to personal reasons. Subsequent to 19 months of follow-up examinations using CT and colonoscopy every 6 months, the patient exhibited no signs of recurrence. Thus, laparoscopic subtotal colectomy represents an effective surgical approach for the treatment of synchronous colorectal cancer following imaging and endoscopic diagnosis.
同时性结直肠癌是指在同一患者体内同时出现多个结直肠肿瘤,不包括其他器官的任何转移瘤。目前,根治性手术被认为是标准的治愈性治疗方法;然而,个体化的手术策略取决于肿瘤位置、浸润深度和患者的一般健康状况。在本研究中,报告了一名52岁男性患者的病例,该患者有2个月的腹痛病史,伴有间歇性便血和体重减轻。患者无癌症家族史。腹部计算机断层扫描(CT)显示横结肠肠壁增厚以及结肠肝曲扭转。结肠镜检查发现3个肿瘤:第一个肿瘤位于距肛缘约60 cm的降结肠,伴有管腔狭窄;第二个肿瘤位于结肠肝曲;第三个肿瘤位于距肛缘23 cm的乙状结肠。随后,进行了腹腔镜次全结肠切除术,切除了所有3个肿瘤,并通过组织病理学检查确诊。由于个人原因,患者术后未接受化疗。在每6个月进行一次CT和结肠镜检查的19个月随访之后,患者未出现复发迹象。因此,腹腔镜次全结肠切除术是成像和内镜诊断后治疗同时性结直肠癌的一种有效手术方法。