[A resected case of bleeding rectal cancer for Jehovah's Witness enabled with preceding colostomy and chemoradiation].
A 66-year-old woman, complaining of anal bleeding with anemia, was examined and diagnosed as advanced rectal cancer. Hemoglobin level at admission was 8.8 g/dL. Abdominal CT and MRI revealed a solid tumor of 43x45 mm in diameter. Colostomy was preceded for the purpose of bleeding control under the blood-augmented treatment on the 7th day of hospitalization. Preoperative chemoradiation was performed (a total of 40 Gy radiation+FOLFOX4 for 1 cycle) and obtained a significant size reduction of the tumor (reduction rate 75%). Abdomino-perineal resection of rectum was performed with 550 mL of hemodilutional autotransfusion 3 months after the initiation of treatment. Pathological findings showed moderately differentiated adenocarcinoma with Stage III a. Vaginal fistula as an irradiation associated with complication was healed by duly performed debridement. The patient has survived for 31 months with no recurrence, which indicates that preceded colostomy and preoperative chemoradiation enabled a curative resection safely for the Jehovah's Witness patient with bleeding advanced rectal cancer.
Suzuki
Asami
A
Department of Surgery, Fukuoka Tokushukai Medical Center.
Kawamoto
Shunji
S
Inada
Kazuo
K
Yamamoto
Nobuharu
N
Kojima
Taibo
T
Nagao
Shuji
S
Ochiai
Ryoji
R
D000368:Aged; D001804:Blood Transfusion, Autologous; D003125:Colostomy; D003131:Combined Modality Therapy; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology; D006801:Humans; D033221:Jehovah's Witnesses; D012004:Rectal Neoplasms / Q000628:therapy*