Staged Treatment for Obstructive Colon Cancer with Severe Aortic Valve Stenosis following Insertion of a Colonic Stent of Two Cases

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  • SAKAMOTO Asuna
    Department of Cardiovascular Surgery, Kagawa Prefectural Central Hospital
  • SUEZAWA Takanori
    Department of Cardiovascular Surgery, Kagawa Prefectural Central Hospital
  • HAYASIDA Tomohiro
    Department of Cardiovascular Surgery, Kagawa Prefectural Central Hospital
  • YANO Masaaki
    Department of Digestive Surgery, Kagawa Prefectural Central Hospital
  • OTANI Hiroki
    Department of Digestive Surgery, Kagawa Prefectural Central Hospital
  • OHASHI Ryuichiro
    Department of Digestive Surgery, Kagawa Prefectural Central Hospital

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Other Title
  • 大腸stentを挿入して弁治療を先行した大動脈弁狭窄症併存閉塞性大腸癌の2例
  • 症例 大腸stentを挿入して弁治療を先行した大動脈弁狭窄症併存閉塞性大腸癌の2例
  • ショウレイ ダイチョウ stent オ ソウニュウ シテ ベン チリョウ オ センコウ シタ ダイドウミャクベン キョウサクショウ ヘイソン ヘイソクセイ ダイチョウガン ノ 2レイ

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Abstract

Obstructive colorectal cancer is an oncologic emergency and requires urgent treatment. The presence of severe aortic valve stenosis (AS) is a risk factor for noncardiac surgery. Two patients with obstructive colon cancer with AS who underwent cardiac surgery before subsequent sigmoidectomy are reported. The first patient was a 73-year-old man who was transferred to our hospital with severe AS and obstructive sigmoid colon cancer. Fasting therapy, which was used at the previous hospital, was stopped after the insertion of a colonic stent. Aortic valve replacement and subsequent conventional sigmoidectomy were performed under controlled nutritional conditions. The interval stent between insertion and sigmoidectomy was 57 days. The second patient was a frail 79-year-old man with severe AS, angina pectoris, obstructive sigmoid colon cancer, and liver metastasis. After insertion of the colonic stent and removal of the ileus tube, oral intake was initiated. Percutaneous coronary intervention, transcatheter aortic valve implantation, and subsequent laparoscopic sigmoidectomy were performed uneventfully. The interval between insertion and sigmoidectomy was 45 days. A colonic stent could be useful in maintaining the perioperative nutritional condition and activities of daily living of patients who require staged surgical treatment.

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