title: [Devastating surgical complications after aflibercept chemotherapy].
abstract: BACKGROUND
  The use of a new chemotherapy as adjuvant treatment of colorectal cancer is not free of complications. Monoclonal antibodies are associated with bleeding and intestinal perforations.
  
  
  OBJECTIVE
  To report the case of a patient who developed a serious complication after treatment with an antiangiogenic drug for colorectal neoplasm.
  
  
  METHODS
  The case is presented of a 42-year-old male operated on due to subocclusive rectal cancer with metástasis at the time of diagnosis. Sixteen months after surgery during second-line adjuvant therapy, an intestinal perforation was observed with haemorrhage and intestinal leak to retroperitoneum and left lower extremity. Despite intensive medical and surgical treatment this complication had fatal consequences.
  
  
  CONCLUSIONS
  Future research should be directed at obtaining biomarkers for the specific use of antiangiogenic agents in order to decrease the rate of adverse factors.
authors.affiliation: Sección de Coloproctología, Servicio de Cirugía General, Hospital Clínico Universitario de Zaragoza, Zaragoza, España. Electronic address: esti.egallego@hotmail.com.
authors.forename: Estíbaliz
authors.initials: E
authors.lastname: Echazarreta-Gallego
authors.affiliation: Sección de Coloproctología, Servicio de Cirugía General, Hospital Clínico Universitario de Zaragoza, Zaragoza, España.
authors.forename: Manuela
authors.initials: M
authors.lastname: Elía-Guedea
authors.affiliation: Sección de Coloproctología, Servicio de Cirugía General, Hospital Clínico Universitario de Zaragoza, Zaragoza, España.
authors.forename: Elena
authors.initials: E
authors.lastname: Córdoba-Díaz de Laspra
mesh_terms: D000038:Abscess / Q000209:etiology / Q000601:surgery; D000230:Adenocarcinoma / Q000188:drug therapy / Q000556:secondary / Q000601:surgery; D000328:Adult; D020533:Angiogenesis Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D017024:Chemotherapy, Adjuvant; D003125:Colostomy; D017577:Cutaneous Fistula / Q000209:etiology; D004322:Drainage; D000071938:Fasciotomy; D017809:Fatal Outcome; D005402:Fistula / Q000209:etiology; D006801:Humans; D007412:Intestinal Fistula / Q000209:etiology; D007416:Intestinal Perforation / Q000209:etiology; D007418:Intestinal Pseudo-Obstruction / Q000209:etiology; D007866:Leg; D008113:Liver Neoplasms / Q000556:secondary / Q000601:surgery; D008297:Male; D054843:Negative-Pressure Wound Therapy; D011183:Postoperative Complications / Q000139:chemically induced* / Q000209:etiology; D040262:Receptors, Vascular Endothelial Growth Factor / Q000627:therapeutic use; D011993:Recombinant Fusion Proteins / Q000009:adverse effects* / Q000627:therapeutic use; D012004:Rectal Neoplasms / Q000188:drug therapy / Q000601:surgery; D012187:Retroperitoneal Space; D012771:Shock, Hemorrhagic / Q000139:chemically induced*
chemical_list: D020533:Angiogenesis Inhibitors; D011993:Recombinant Fusion Proteins; C533178:aflibercept; D040262:Receptors, Vascular Endothelial Growth Factor
keywords: Aflibercept; Agentes antiangiogénicos; Antiangiogenic agents; Colorectal neoplasms; Intestinal perforation; Neoplasia colorrectal; Perforación intestinal