TREATMENT OF RECTAL AND RECTOSIGMOID CANCER COMPLICATED BY TUMOR BLEEDING USING THE METHOD OF X-RAY-ENDOVASCULAR HEMOSTASIS
https://doi.org/10.21294/1814-4861-2016-15-5-55-59
Abstract
Short-term treatment outcomes of X-ray endovascular hemostasis in patients with rectosigmoid and rectal cancer complicated by bleeding were presented. Patients were divided into two groups. Group I (study group) consisted of 16 patients who underwent x-ray-endovascular hemostasis. Group II (control group) included 17 patients who received conservative methods of hemostasis. After hemostasis, patients with rectal cancer from both groups received preoperative radiotherapy followed by radical surgery. Patients with rectosigmoid cancer underwent surgery alone. The components derived from donated blood were used in a significantly larger volume in patients from the control group than in patients from the study group (p<0.01), with the same median estimated blood loss. Recurrence of bleeding was observed on 13.3 ± 1.6 days in 100 % of control group patients. There was no evidence of bleeding recurrence in the study group patients. The relative risk reduction of bleeding was 100 % in Group I patients. Thus, the method of X-ray-endovascular hemostasis allows intraluminal tumor bleeding completely to be stopped avoiding repeated blood transfusions.
About the Authors
A. V. Shelekhov
Department of Oncology of Irkutsk State Medical Academy of Postgraduate Education, Russia, Irkutsk 32, Frunze Street, 664042-Irkutsk, Russia
Russian Federation
Russian Federation
MD, DSc, Professor, Oncology Department, Irkutsk State Medical Academy of Continuing Education (Irkutsk, Russian Federation)
V. V. Dvornichenko
Department of Oncology of Irkutsk State Medical Academy of Postgraduate Education, Russia, Irkutsk 32, Frunze Street, 664042-Irkutsk, Russia
Russian Federation
Russian Federation
MD, DSc, Professor, Oncology Department, Irkutsk State Medical Academy of Continuing Education (Irkutsk, Russian Federation)
A. V. Munkuev
Department of Oncology of Irkutsk State Medical Academy of Postgraduate Education, Russia, Irkutsk 32, Frunze Street, 664042-Irkutsk, Russia
Russian Federation
MD, angiosurgeon, Irkutsk Regional Cancer Center (Irkutsk, Russian Federation)
Russian Federation
MD, angiosurgeon, Irkutsk Regional Cancer Center (Irkutsk, Russian Federation)
R. I. Rasulov
Department of Oncology of Irkutsk State Medical Academy of Postgraduate Education, Russia, Irkutsk 32, Frunze Street, 664042-Irkutsk, Russia
Russian Federation
Russian Federation
MD, DSc, Professor, Oncology Department, Irkutsk State Medical Academy of Continuing Education (Irkutsk, Russian Federation)
S. I. Radostev
Department of Oncology of Irkutsk State Medical Academy of Postgraduate Education, Russia, Irkutsk 32, Frunze Street, 664042-Irkutsk, Russia
Russian Federation
MD, physician, Regional Cancer Center (Irkutsk, Russian Federation)
Russian Federation
MD, physician, Regional Cancer Center (Irkutsk, Russian Federation)
R. A. Zubkov
Department of Oncology of Irkutsk State Medical Academy of Postgraduate Education, Russia, Irkutsk 32, Frunze Street, 664042-Irkutsk, Russia
Russian Federation
Russian Federation
MD, PhD, Oncology Department, Irkutsk State Medical Academy of Continuing Education (Irkutsk, Russian Federation)
References
1. Aleksandrov V.B. Colorectal Cancer. M.: University book; 2001, 208 p. [in Russian]
2. Francisco R., Díaz G., Cadahia V., Velázquez R.F., Giganto F., González O., Rodrigo L. Lower GI bleeding secondary to a stromal rectal tumor (rectal GIST). Rev Esp Enferm Dig. 2006 May; 98 (5): 387–9.
3. Ohhigashi S., Nishio T., Watanabe F., Matsusako M. Experience with radiofrequency ablation in the treatment of pelvic recurrence in rectal cancer: report of two cases. Dis Colon Rectum. 2001 May; 44 (5): 741–5.
4. Breen E. Pathophysiology and natural history of lower gastrointestinal bleeding // Semin. Colon Rectal Surg. 1997; 8 (12). P. 128-138.
5. Hoedema R.E., Luchtefeld M.A. The management of lower gastrointestinal hemorrhage. Dis Colon Rectum. 2005 Nov; 48 (11): 2010–24.
6. Liu L., Cao C., Zhu Y., Li D., Feng H., Luo J., Tang Z., Liu P., Lu K., Ju H., Zhang N. Preoperative chemoradiotherapy with 5-fluorouracil and oxaliplatin for locally advanced rectal cancer: long-term results of a phase II trial. Med Oncol. 2015 Mar; 32 (3): 70. doi: 10.1007/s12032-015-0512-3.
7. Vorob’ev A.I. Acute massive blood loss. M.: GOATER-MED; 2001, 176 p. [in Russian]
8. Ermolov A.S., Sakharov E.A., Khudenko N.V. Quantitative estimation of the volume and severity of intraoperative blood loss in surgical practice. The Hematology and Transfusiology. 2005; 4 (50): 27–32. [in Russian]
9. Bessmertnyi B.S. Mathematical statistics in clinical, preventive and experimental medicine. Moscow: Meditsina; 1967. 304 p. [in Russian]
10. Begg C., Cho M., Eastwood S., Horton R., Moher D., Olkin I., Pitkin R., Rennie D., Schulz K.F., Simel D., Stroup D.F. Improving the quality of reporting of randomized controlled trials: the CONSORT statement JAMA. 1996 Aug 28; 276 (8): 637– 9.
11. Tohmé C., Chakhtoura G., Abboud B., Noun R., Sarkis R, Ingea H., Farah P, Ghossain A. Subtotal or total colectomy as surgical treatment of left-sided occlusive colon cancer. J Med Liban. 2008 Oct-Dec; 56 (4): 198–202.
12. Hsu T.C. One-Stage resection and anastomosis for acute obstruction of the left colon. Diseases of the Colon & Rectum. 1998; 41 (Issue 1): 28–32.
13. Vetter C. Preoperative radio-chemotherapy in rectal carcinoma. Forestalling colostomy. MMW Fortschr Med. 2003 Oct 9; 145 (41): 13.
14. Coco C., Verbo A., Manno A., Mattana C., Covino M., Pedretti G., Petito L., Rizzo G., Picciocchi A. Impact of emergency surgery in the outcome of rectal and left colon carcinoma. World J Surg. 2005 Nov; 29 (11): 1458–64.
15. Corsale I., Foglia E., Mandato M., Rigutini M. Intestinal occlusion caused by malignant neoplasia of the colon: surgical strategy. G Chir. 2003 Mar; 24 (3): 86– 91.
16. Afanasyev S.G., Startseva Zh.А., Tarasova А.S., Usova А.V., Samtsov Е.N. Results of combined modality treatment including preoperative plolonged chemotherary for rectal cancer. Siberian Journal of Oncology. 2012. 6: 5–12. [in Russian]
17. Olshansky M.S., Korotkikh N.N., Evteev V.V. Immediate and long term results of using selective chemoembolization of rectal arteries in the complex treatment of rectal cancer. Medical science. 2012; 2: 321–324. [in Russian]
18. Bloomfeld R.S., Rockey D.C., Shetzline M.A. Endoscopic therapy of acute diverticular hemorrhage. Am J Gastroenterol. 2001 Aug; 96 (8): 2367–72.
19. Jensen D.M., Machicado G.A., Jutabha R., Kovacs T.O. Urgent colonoscopy for the diagnosis and treatment of severe diverticular hemorrhage. N Engl J Med. 2000 Jan 13; 342 (2): 78–82.
20. Kovacs T.O., Jensen D.M. Recent advances in the endoscopic diagnosis and therapy of upper gastrointestinal, small intestinal, and colonic bleeding. Med Clin North Am. 2002 Nov; 86 (6): 1319–56.
21. Vernava A.M., Moore B.A., Longo W.E., Johnson F.E. Lower gastrointestinal bleeding. Dis Colon Rectum. 1997 Jul; 40 (7): 846–58.
Review
For citations:
Shelekhov A.V., Dvornichenko V.V., Munkuev A.V., Rasulov R.I., Radostev S.I., Zubkov R.A. TREATMENT OF RECTAL AND RECTOSIGMOID CANCER COMPLICATED BY TUMOR BLEEDING USING THE METHOD OF X-RAY-ENDOVASCULAR HEMOSTASIS. Siberian journal of oncology. 2016;15(5):55-59. (In Russ.) https://doi.org/10.21294/1814-4861-2016-15-5-55-59
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