大腸ステントが逸脱し緊急手術となった1例

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  • A patient who underwent emergency surgery because of a migrated colonic stent

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The patient was a 74-year-old man with rectal cancer. A colonic stent was placed at the site of a stricture of the rectum to alleviate the symptoms of ileus. FOLFIRI (70%) was given as preoperative chemotherapy. However, the patient developed anal pain and anorexia after 2 courses of treatment, and the chemotherapy was discontinued. He strongly desired surgical therapy and was admitted for preoperative evaluation. Abdominal radiography revealed that the colonic stent was lodged in the anus.<br> Endoscopic examination confirmed that the stent was lodged in the mucosa of the anal canal. Because there was a high risk of perforation, surgery was performed. With the patient under general anesthesia, the stent was manually removed transanally. A Hartmann’s procedure was concurrently performed. The patient recovered uneventfully after the surgery and was discharged. FOLFOX was given as postoperative chemotherapy. The patient is currently receiving treatment on an outpatient basis, with no adverse events.<br> We described our experience with a patient in whom chemotherapy-induced tumor shrinkage apparently led to migration of a colonic stent. Because of the increasing number of patients undergoing colonic stent implantation, the safety of concurrent chemotherapy and methods to remove migrated stents should be reconsidered.

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