Surgical Procedure for Sporadic Colorectal Cancer in Patients with Mild Ulcerative ColitisUchino M.a · Ikeuchi H.a · Matsuoka H.a · Bando T.a · Hirata A.a · Yasukawa S.c · Takesue Y.b · Tomita N.a
aDepartment of Lower Gastroenterological Surgery and bDivision of Infection Control and Prevention, Hyogo College of Medicine, Nishinomiya, and cDepartment of Surgical Pathology, Kyoto Prefectural University of Medicine, Kyoto, Japan Corresponding Author
Motoi Uchino, MD, PhD
Department of Lower Gastroenterological Surgery, Hyogo College of Medicine
Mukogawa-cho, Nishinomiya, Hyogo 663-8501 (Japan)
Restorative proctocolectomy is recognized as the standard procedure for colitic cancer in patients with ulcerative colitis (UC). However, whether this represents the optimal procedure for UC patients with sporadic cancer remains questionable, as functional quality of life differs substantially between patients with proctocolectomy and partial resection. This study considered possible problems associated with sporadic cancer in UC. Case 1 is a 55-year-old man with a 3-year history of UC who was treated with endoscopic resection for sporadic adenocarcinoma in the rectum. Low anterior resection was subsequently performed due to deep invasion. The final diagnosis was pT3. Differentiating between histopathological diagnoses of sporadic and colitic cancer was difficult. Case 2 is a 71-year-old woman with a 6-year history of UC who was diagnosed with type 1 sporadic sigmoid colon cancer. Dementia and umbilical hernia were present as complications. Total colectomy was performed in consideration of the coexisting complications. Although partial resection for sporadic cancer could be favorable in mild colitis, further immunosuppressive treatments have the potential to elevate the risk of recurrence for advanced cancer. Restorative proctocolectomy may be safer to avoid further recurrent colitis and cancer except in elderly patients or those with other complications.
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