内容紹介
Summary
The patient-a Jehovah's Witness-was a woman in her 60s, with locally advanced sigmoid colon cancer. She had severe anemia, and a computed tomography scan of her abdomen showed a tumor with abscess formation and perforation that had invaded into the left urinary duct and the left ovary, without distant metastasis. It was difficult to perform curative resections without transfusion; therefore, CapeOX therapy was planned as the neoadjuvant treatment. After 3 courses of CapeOX therapy, the patient's anemia improved, and the tumor and abscess had shrunk. Subsequently, a sigmoidectomy with D3 lymph node dissection, partial resection of the small intestine, and the left adnexectomy, as a radical surgery, were performed without blood transfusion. In cases of concomitant colon cancer with anemia that are treated with highly invasive surgery, it might be necessary to conduct systematic treatment in order to complete non-transfusion therapy.
要旨
症例は60歳台,女性。輸血拒否者。貧血(Hb 6.2 g/dL)の原因精査で膿瘍,水腎症を伴うS状結腸癌と診断した。無輸血での根治切除は困難と判断し,横行結腸人工肛門造設後CapeOX療法を3コース施行した。貧血の改善と腫瘍,膿瘍の縮小を認めたため,S状結腸切除術,D3郭清,小腸部分・左付属器合併切除術を施行し,無輸血で根治切除し得た。術前化学療法は貧血を有する高侵襲手術で無輸血治療を完遂するための有用な手段と考えられた。
目次
The patient-a Jehovah's Witness-was a woman in her 60s, with locally advanced sigmoid colon cancer. She had severe anemia, and a computed tomography scan of her abdomen showed a tumor with abscess formation and perforation that had invaded into the left urinary duct and the left ovary, without distant metastasis. It was difficult to perform curative resections without transfusion; therefore, CapeOX therapy was planned as the neoadjuvant treatment. After 3 courses of CapeOX therapy, the patient's anemia improved, and the tumor and abscess had shrunk. Subsequently, a sigmoidectomy with D3 lymph node dissection, partial resection of the small intestine, and the left adnexectomy, as a radical surgery, were performed without blood transfusion. In cases of concomitant colon cancer with anemia that are treated with highly invasive surgery, it might be necessary to conduct systematic treatment in order to complete non-transfusion therapy.
要旨
症例は60歳台,女性。輸血拒否者。貧血(Hb 6.2 g/dL)の原因精査で膿瘍,水腎症を伴うS状結腸癌と診断した。無輸血での根治切除は困難と判断し,横行結腸人工肛門造設後CapeOX療法を3コース施行した。貧血の改善と腫瘍,膿瘍の縮小を認めたため,S状結腸切除術,D3郭清,小腸部分・左付属器合併切除術を施行し,無輸血で根治切除し得た。術前化学療法は貧血を有する高侵襲手術で無輸血治療を完遂するための有用な手段と考えられた。