alexa Laparoscopic Colectomy for Colon Cancer with Retroperitoneal Abscess Treated with Initial Conservative Therapy: A Report of Three Cases with a Literature Review
ISSN: 2165-7920

Journal of Clinical Case Reports
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Case Report

Laparoscopic Colectomy for Colon Cancer with Retroperitoneal Abscess Treated with Initial Conservative Therapy: A Report of Three Cases with a Literature Review

Genta Sawada1*, Ken Nakata1*, Masaki Tsujie1, Koji Amano2, Jota Mikami1, Tomoya Kishimoto1, Shin Nakahira1, Yoichi Makari1, Junya Fujita1 and Hiroki Ozato1

1Department of Surgery, Sakai City Medical Center, Japan

2Department of Trauma and Acute Care Surgery, Sakai City Medical Center, Japan

*Corresponding Author:
Genta Sawada
Ken Nakata, Department of Surgery
Sakai City Medical Center, Japan
Tel: +81-72-272-1199
Fax: +81-72-272-9911
E-mail: [email protected]

Received Date: May 06, 2017; Accepted Date: June 12, 2017; Published Date: June 16, 2017

Citation: Sawada G, Nakata K, Tsujie M, Amano K, Mikami J, et al. (2017) Laparoscopic Colectomy for Colon Cancer with Retroperitoneal Abscess Treated with Initial Conservative Therapy: A Report of Three Cases with a Literature Review. J Clin Case Rep 7:975. doi: 10.4172/2165-7920.1000975

Copyright: © 2017 Sawada G, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

 

Abstract

Background: Colon cancer rarely invades the retroperitoneum and surrounding organs, such as the iliopsoas muscle, resulting in retroperitoneal abscesses. We present three cases of colon cancer with retroperitoneal abscesses (CRA, treated using different initial conservative therapies (ICTs, followed by laparoscopic surgery. We also reviewed 18 cases of CRA reported in Japanese literature from 2000 to 2016.

Case presentation: In Case 1 and 2, patients underwent abscess drainage as ICT. In Case 3, the patient diagnosed with cecum cancer underwent initial treatment with separation surgery, which isolated the right side of the colon from the left side and created a mucus fistula of the right-side colon to prevent stool from running through the lesion. In all cases, ICT combined with antibiotic therapy improved the general condition of the patients and reduced the volume of the abscess cavity, enabling a laparoscopic surgery to be performed. All cases underwent en bloc resection of the main tumor and invaded organ with adequate lymph node dissection. Rather than attempting complete resection of the entire abscess cavity, the debridement of the abscess cavity was performed. Although one patient complained of mild neuropathic pain of the left thigh after surgery, the postoperative clinical courses of the three patients were almost uneventful. The follow-up periods of Case 1, 2, and 3 were 24, 6, and 2 months respectively, and they have shown no signs of recurrence after surgery.

Conclusion: Following a review of 18 CRA cases, ICT for CRA didn’t make any significant differences in postoperative complication and length of hospital stay compared with surgery alone. However, based on our cases, ICT before surgery clearly provided benefit to the patients and made the use of laparoscopic surgery possible. ICT can be a useful strategy for the treatment of CRA.

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