Wang Mengyuan, Zao Xiaobin, Ge Zhiming, Fan Xianxian, Jin Li, Zhang Jiucun, Zhao Hongbo, Tie Baoxia, Liang Yijun, Song Lianying, Liu Jinglong, Wang Yifei, Zhang Shuxin, Yang Yun
Anorectal Department, Yinchuan Traditional Chinese Medicine Hospital, Ningxia Medical University, Yinchuan, Ningxia Hui Autonomous Region 750001, P.R. China.
Key Laboratory of Chinese Internal Medicine of Ministry of Education and Beijing, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing 100700, P.R. China.
Oncol Lett. 2024 Aug 13;28(4):497. doi: 10.3892/ol.2024.14630. eCollection 2024 Oct.
Colon adenocarcinoma (COAD) is a malignant tumor type. Fever is the most common postoperative complication of COAD. The present study described the treatment of a patient with early-stage COAD with precancerous colon polyps and the possible cause of postoperative fever. The patient was a 48-year-old woman with intermittent hematochezia, defecation urgency and liquid feces. The patient received surgical treatment, a whole segment from the intestine was removed, which contained a 4-cm-long mass and a 2-cm-long firm mass. Within 3 days after the operation, the patient's incision healed well, but the body temperature increased to a range of 37.8-38.6°C. The suture was removed on the 10th postoperative day. After another three days, it was discovered that the upper end of the patient's surgical incision split to the anterior rectus abdominis sheath. The patient was provided with recombinant human acidic fibroblast growth factor to promote wound healing. The patient was finally diagnosed with rectosigmoid junction adenocarcinoma and precancerous colon polyps according to pathological examination results. The patient was given intravenous bevacizumab combined with irinotecan hydrochloride and oral capecitabine, and all drugs were repeatedly applied every 3 weeks, and a total of four treatment cycles were used. The cause of this postoperative fever was concluded to be anemia coming from chronic hematochezia and combined with deep wound dehiscence with secondary infection. The present study showcased that low-dose and short-course prophylactic adjuvant therapy is feasible for early-stage COAD with precancerous colon polyps.
结肠腺癌（COAD）是一种恶性肿瘤类型。发热是COAD最常见的术后并发症。本研究描述了一名患有癌前结肠息肉的早期COAD患者的治疗情况以及术后发热的可能原因。该患者为一名48岁女性，有间歇性便血、排便急迫和稀便症状。患者接受了手术治疗，切除了一段包含一个4厘米长肿物和一个2厘米长实性肿物的肠段。术后3天内，患者切口愈合良好，但体温升至37.8 - 38.6°C。术后第10天拆除缝线。又过了三天，发现患者手术切口上端裂开至腹直肌前鞘。给予患者重组人酸性成纤维细胞生长因子以促进伤口愈合。根据病理检查结果，患者最终被诊断为直肠乙状结肠交界处腺癌和癌前结肠息肉。给予患者静脉注射贝伐单抗联合盐酸伊立替康及口服卡培他滨，所有药物每3周重复应用一次，共进行了四个治疗周期。得出此次术后发热的原因是慢性便血导致的贫血并伴有深部伤口裂开继发感染。本研究表明，低剂量、短疗程预防性辅助治疗对于伴有癌前结肠息肉的早期COAD是可行的。
