Saito Seiji, Yagi Ryoma, Hirai Motoharu, Endo Maiko, Kakuta Tomoyuki, Naito Tetsuya, Minagawa Masahiro, Tani Tatsuo, Shimakage Naohiro
Dept. of Surgery, Nagaoka Red Cross Hospital.
Gan To Kagaku Ryoho. 2020 Dec;47(13):2323-2325.
Essential thrombocythemia(ET)is a rare myeloproliferative disorder characterized by thrombocytosis and a risk of thrombotic and hemorrhagic events. ET rarely occurs simultaneously with colorectal cancer. Including our case, only 5 cases of c o l orectal cancer with ET have been reported in Japan. Herein, we report a case of colon cancer in an ET patient who underwent laparoscopic right hemicolectomy. Our perioperative management avoided complications such as thrombosis or bleeding. An 81-year-old woman developed bloody stools. She was previously diagnosed with ET 9 years ago. Aspirin, cilostazol, and hydroxyurea(HU)were prescribed. Colonoscopy revealed a tumor at the ascending colon. Histopathological examination showed a well-differentiated tubular adenocarcinoma. Since the patient had anemia, aspirin and cilostazol were discontinued after diagnosis. HU was discontinued from the day before surgery to 2 days after surgery. Enoxaparin was subcutaneously administered for 1 to 3 days after surgery. Aspirin and cilostazol were resumed on the fourth day post-surgery. The patient could be discharged when her condition stabilizes with no thrombosis and bleeding after 8 days.
原发性血小板增多症（ET）是一种罕见的骨髓增殖性疾病，其特征为血小板增多以及存在血栓形成和出血事件的风险。ET极少与结直肠癌同时发生。包括我们的病例在内，日本仅报道过5例合并ET的结直肠癌病例。在此，我们报告1例接受腹腔镜右半结肠切除术的ET患者的结肠癌病例。我们的围手术期管理避免了血栓形成或出血等并发症。一名81岁女性出现便血。她9年前被诊断为ET。曾服用阿司匹林、西洛他唑和羟基脲（HU）。结肠镜检查发现升结肠有肿瘤。组织病理学检查显示为高分化管状腺癌。由于患者患有贫血，诊断后停用了阿司匹林和西洛他唑。术前1天至术后2天停用HU。术后皮下注射依诺肝素1至3天。术后第4天恢复使用阿司匹林和西洛他唑。患者病情稳定，术后8天无血栓形成和出血，随后出院。
