Preoperative rectal tumor embolization as an adjunctive tool for bloodless abdominoperineal excision:A case report

• 作者: Antonio Balestrim Filho Daniel Giansante Abud Guilherme Seizem Nakiri Jose Joaquim Ribeiro da Rocha Ligia Magnani Landell Lucas Fernandes de Freitas Mariângela Ottoboni Brunaldi Marley Ribeiro Feitosa Omar Feres Rogério Serafim Parra
• 来源期刊: 世界临床肿瘤学杂志:英文版
• 学科: 医学
• 关键词: Rectal neoplasms PROCTECTOMY Bloodless medical and surgical procedures Embolization therapeutic Colorectal surgery Case report
• 年，卷（期）: 2020,（12）
• 页码范围: 1070-1075
• 页数: 6页
• 分类号: R73

摘要

BACKGROUND Abdominoperineal excision(APE)-related hemorrhage can be challenging due to difficult access to pelvic organs and the risk of massive blood loss.The objective of the present study was to demonstrate the use of preoperative embolization(PE)as a strategy for blood preservation in a patient with a large low rectal tumor with a high risk of bleeding,scheduled for APE.CASE SUMMARY A 56-year-old man presented to our institution with a one-year history of anal bleeding and rectal tenesmus.The patient was diagnosed with bulky adenocarcinoma limited to the rectum.As the patient refused any clinical treatment,surgery without previous neoadjuvant chemoradiation was indicated.The patient underwent a tumor embolization procedure,two days before surgery performed via the right common femoral artery.The tumor was successfully devascularized and no major bleeding was noted during APE.Postoperative recovery was uneventful and a one-year follow-up showed no signs of recurrence.CONCLUSION Therapeutic tumor embolization may play a role in bloodless surgeries and increase surgical and oncologic prognoses.We describe a patient with a bulky low rectal tumor who successfully underwent preoperative embolization and bloodless abdominoperineal resection.