2 . 2019

Multidisciplinary sphincter-saving surgical treatment of synchronous colorectal cancer

Abstract

The aim – demonstration of the modern possibilities of the multidisciplinary approach in the sphincter-saving treatment of multiple synchronous colorectal cancer.
A multistage treatment of multiple synchronous colorectal cancer, including neoplasms of the lower part of rectum, has been described. Neoadjuvant chemotherapy was used for downstaging and downsizing of tumor to preserve the sphincter. Adenomatous polyps were removed endoscopically at the preoperative stage. The patient has been performed ultra-low anterior resection of the rectum with extended paraaortic and lateral lymph node dissection. In the future, adjuvant chemotherapy was performed. Recurrence was not observed within 12 months after surgical treatment.

Conclusion. Neoadjuvant chemotherapy can be used instead of chemoradiotherapy, thereby opening up the possibility of performing sphincter-saving operations with a low location of rectal cancer. Despite the risks of developing local recurrence, it is possible to reduce the likelihood of a negative outcome and achieve acceptable functional results in multistage and multidisci- plinary treatment. Performing an expanded para-aortic and lateral lymph node dissection can reduce the risk of developing distant metastasis.

Keywords:surgery, colorectal cancer, chemotherapy

For citation: Lukyanov A.M., Kitsenko Yu.E., Efetov S.K., Fedorov D.N., Tulina I.A., Tsarkov P.V. Multidisciplinary sphinctersaving surgical treatment of synchronous colorectal cancer. Clin Experiment Surg. Petrovsky J. 2019; 7 (2): 79–84. doi: 10.24411/2308-1198-2019-12011. (in Russian)
Received 20.11.2018. Accepted 22.04.2019.

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