Ersan Veysel, Kutlu Ramazan, Erdem Ceyhun, Karagul Servet, Kayaalp Cuneyt
Department of Surgery, Inonu University, Malatya, Turkey.
Department of Radiology, Inonu University, Malatya, Turkey.
J Transl Int Med. 2017 Sep 30;5(3):186-188. doi: 10.1515/jtim-2017-0026. eCollection 2017 Sep.
Fund of knowledge on palliative treatment of unresectable retrorectal tumors is scare. Here, we reported a non-surgical treatment of a huge retrorectal malignant tumor in an aged and debilitated patient complicated with colorectal obstruction. An 86-year-old male with severe comorbidities was admitted with acute colorectal obstruction owing to an untreated retrorectal malign epithelial tumor. There was a lobulated retrorectal mass, 20 cm × 15 cm at largest size, extending to the superior iliac bifurcation level, caused an obstruction of the rectal lumen. He was not suitable for surgical excision because of the severe comorbidities. Rectal obstruction was palliated by two self-expandable metallic stents. He tolerated the procedures well and post-procedural course was uneventful. After four months, stents were patent and the patient was continent. Stenting for colorectal obstruction owing to a retrorectal tumor can be feasible in patients who are not suitable for surgery (aged, debilitated, advanced tumor). It avoided the surgical trauma to a high-risk patient and ensured the continuity of continence. As far as we know, this was the first report on colorectal stenting for a retrorectal tumor.
关于不可切除的直肠后肿瘤姑息治疗的知识储备匮乏。在此，我们报告了一例老年体弱患者合并大肠梗阻的巨大直肠后恶性肿瘤的非手术治疗。一名患有严重合并症的86岁男性因未治疗的直肠后恶性上皮肿瘤导致急性大肠梗阻入院。有一个分叶状的直肠后肿物，最大尺寸为20 cm×15 cm，延伸至髂总动脉分叉水平，导致直肠管腔梗阻。由于严重的合并症，他不适合手术切除。通过两个自膨式金属支架缓解了直肠梗阻。他对手术耐受良好，术后过程顺利。四个月后，支架通畅，患者大便自控。对于不适合手术（年龄大、体弱、肿瘤晚期）的患者，因直肠后肿瘤导致的大肠梗阻行支架置入术可能是可行的。它避免了对高危患者的手术创伤，并确保了大便自控的连续性。据我们所知，这是关于直肠后肿瘤大肠支架置入术的首例报道。
