title: Transjugular Intrahepatic Portosystemic Shunt and Laparoscopic Colorectal Resection: the ideal minimally-invasive management for the treatment of colorectal cancer in severe cirrhotic patients. A case report and literature review.
abstract: Surgical interventions on gastrointestinal tract are often not well tolerated by patients with cirrhosis and severe portal hypertension, impairing their prognosis if suffering from malignant disease. Combining the benefits of two minimally invasive techniques such as Transjugular intrahepatic portosystemic shunt (TIPS) and Laparoscopic Colorectal Resection (LCR), the complications related to surgical intervention might be reduced and thus, it allows patients with liver disease, to undergo a curative intervention. One patient with cirrhosis and portal hypertension diagnosed with a rectal cancer underwent a meticulous preoperative preparation through placement of TIPS before laparoscopic surgery. TIPS placement was performed without intraprocedure complications. The patient was successfully operated by laparoscopic technique 36 days after TIPS placement without intraoperative bleeding or postoperative complications. Our experience, despite being based on one case, allows us to conclude that decompression of portal system by TIPS, already used in open surgery, may be applicable as a preoperative laparoscopic procedure with equally satisfactory results.
authors.affiliation: Luxembourg Hospital Centre, Luxembourg. azagra.js@chl.eu
authors.forename: L
authors.initials: L
authors.lastname: De Magistris
authors.forename: J S
authors.initials: JS
authors.lastname: Azagra
authors.forename: M
authors.initials: M
authors.lastname: Goergen
authors.forename: D
authors.initials: D
authors.lastname: Manzoni
authors.forename: M
authors.initials: M
authors.lastname: Herrero-Lopez
authors.forename: S
authors.initials: S
authors.lastname: Sofos
mesh_terms: D015179:Colorectal Neoplasms / Q000150:complications / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy; D008103:Liver Cirrhosis / Q000150:complications; D008297:Male; D008875:Middle Aged; D019168:Portasystemic Shunt, Transjugular Intrahepatic; D012720:Severity of Illness Index