Management of colorectal cancer in patients with cirrhosis and a LeVeen shunt.
Two cirrhotic patients with a LeVeen shunt presented with a large bowel cancer. In one patient, the shunt was removed and the venous catheter was ligated prior to the performance of a colon resection. The postoperative course was uneventful. A new valve was inserted and connected to the venous catheter two months later. The second patient had a carcinoma of the rectum. In order to prevent ascites and to ease the colorectal resection he had preliminary construction of a portacaval shunt. Six weeks later, he underwent an anterior resection of the rectum. The postoperative course was uneventful except for a self limiting episode of febrile subacute intestinal obstruction. These two cases demonstrate that it is possible to resect colorectal cancer in patients with cirrhosis, ascites and a peritoneovenous shunt provided measures are taken to avoid specific complications due to the presence of the shunt, ascites or portal hypertension.
D000368:Aged; D003110:Colonic Neoplasms / Q000150:complications / Q000601:surgery*; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010536:Peritoneovenous Shunt; D012004:Rectal Neoplasms / Q000150:complications / Q000601:surgery*