A two-step surgery and a multidisciplinary approach in a centenarian patient with an acute presentation of right colon cancer
Abstract Background As surgery remains the cornerstone of colorectal cancer (CRC) treatment, the number of older patients presented for colorectal resection is rapidly increasing. Nevertheless, the choice to operate an oldest-old patient still remain challenging and requires a careful assessment of...
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| Format: | Article |
| Language: | English |
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BMC
2020-03-01
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| Series: | BMC Surgery |
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| Online Access: | http://link.springer.com/article/10.1186/s12893-020-00708-9 |
| _version_ | 1818205062269239296 |
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| author | Chiara Giannotti Andrea Massobrio Daniela Cannata Alessio Nencioni Fiammetta Monacelli Alessandra Aprile Domenico Soriero Stefano Scabini Davide Pertile |
| author_facet | Chiara Giannotti Andrea Massobrio Daniela Cannata Alessio Nencioni Fiammetta Monacelli Alessandra Aprile Domenico Soriero Stefano Scabini Davide Pertile |
| author_sort | Chiara Giannotti |
| collection | DOAJ |
| description | Abstract Background As surgery remains the cornerstone of colorectal cancer (CRC) treatment, the number of older patients presented for colorectal resection is rapidly increasing. Nevertheless, the choice to operate an oldest-old patient still remain challenging and requires a careful assessment of risk to benefit ratio in order to guarantee appropriate surgical strategies and perioperative management. Case presentation A centenarian patient, acutely admitted to the emergency department, was diagnosed with an ileus caused by stenosing ascending colon cancer with abnormal distension of the right colon at high risk of perforation. Facing with this complex clinical scenario, a lateral decompressive cecostomy as alternative surgical procedure, was performed in local anesthesia in order to avoid the stressful event of an emergency surgery. Thereafter, the patient was admitted to the surgical ward and followed by a geriatrician who performed a comprehensive geriatric assessment (CGA) and daily clinical evaluations. This integrated plan of care was mainly focused on rehabilitation, nutritional interventions and therapeutic reconciliation, maximizing patient’s clinical conditions and performance status. Then, the second surgical step, the radical colon surgery with curative intent and bowel continuity reestablishment was performed, demonstrating to be feasible and safety also in a very advanced age patient in term of prolonged survival and preservation of an adequate quality of life. Conclusions This is the first case-report that illustrates a successful two step surgery for CRC in a centenarian patient thanks to a multidisciplinary based approach, overwhelming the mere concept of chronological age. |
| first_indexed | 2024-12-12T03:51:09Z |
| format | Article |
| id | doaj.art-24a175a4011045298a6c978c29100d7a |
| institution | Directory Open Access Journal |
| issn | 1471-2482 |
| language | English |
| last_indexed | 2024-12-12T03:51:09Z |
| publishDate | 2020-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Surgery |
| spelling | doaj.art-24a175a4011045298a6c978c29100d7a2022-12-22T00:39:23ZengBMCBMC Surgery1471-24822020-03-012011810.1186/s12893-020-00708-9A two-step surgery and a multidisciplinary approach in a centenarian patient with an acute presentation of right colon cancerChiara Giannotti0Andrea Massobrio1Daniela Cannata2Alessio Nencioni3Fiammetta Monacelli4Alessandra Aprile5Domenico Soriero6Stefano Scabini7Davide Pertile8Geriatrics Clinic, Department of Internal Medicine and Medical Specialties (DIMI), University of GenoaOncological Surgery, San Martino Hospital, Polyclinic and Institute for Research and CareSan Martino Hospital, Polyclinic and Institute for Research and CareGeriatrics Clinic, Department of Internal Medicine and Medical Specialties (DIMI), University of GenoaGeriatrics Clinic, Department of Internal Medicine and Medical Specialties (DIMI), University of GenoaOncological Surgery, San Martino Hospital, Polyclinic and Institute for Research and CareOncological Surgery, San Martino Hospital, Polyclinic and Institute for Research and CareOncological Surgery, San Martino Hospital, Polyclinic and Institute for Research and CareOncological Surgery, San Martino Hospital, Polyclinic and Institute for Research and CareAbstract Background As surgery remains the cornerstone of colorectal cancer (CRC) treatment, the number of older patients presented for colorectal resection is rapidly increasing. Nevertheless, the choice to operate an oldest-old patient still remain challenging and requires a careful assessment of risk to benefit ratio in order to guarantee appropriate surgical strategies and perioperative management. Case presentation A centenarian patient, acutely admitted to the emergency department, was diagnosed with an ileus caused by stenosing ascending colon cancer with abnormal distension of the right colon at high risk of perforation. Facing with this complex clinical scenario, a lateral decompressive cecostomy as alternative surgical procedure, was performed in local anesthesia in order to avoid the stressful event of an emergency surgery. Thereafter, the patient was admitted to the surgical ward and followed by a geriatrician who performed a comprehensive geriatric assessment (CGA) and daily clinical evaluations. This integrated plan of care was mainly focused on rehabilitation, nutritional interventions and therapeutic reconciliation, maximizing patient’s clinical conditions and performance status. Then, the second surgical step, the radical colon surgery with curative intent and bowel continuity reestablishment was performed, demonstrating to be feasible and safety also in a very advanced age patient in term of prolonged survival and preservation of an adequate quality of life. Conclusions This is the first case-report that illustrates a successful two step surgery for CRC in a centenarian patient thanks to a multidisciplinary based approach, overwhelming the mere concept of chronological age.http://link.springer.com/article/10.1186/s12893-020-00708-9Colon cancerSurgeryCecostomyOldest oldFrailtyComprehensive geriatric assessment |
| spellingShingle | Chiara Giannotti Andrea Massobrio Daniela Cannata Alessio Nencioni Fiammetta Monacelli Alessandra Aprile Domenico Soriero Stefano Scabini Davide Pertile A two-step surgery and a multidisciplinary approach in a centenarian patient with an acute presentation of right colon cancer BMC Surgery Colon cancer Surgery Cecostomy Oldest old Frailty Comprehensive geriatric assessment |
| title | A two-step surgery and a multidisciplinary approach in a centenarian patient with an acute presentation of right colon cancer |
| title_full | A two-step surgery and a multidisciplinary approach in a centenarian patient with an acute presentation of right colon cancer |
| title_fullStr | A two-step surgery and a multidisciplinary approach in a centenarian patient with an acute presentation of right colon cancer |
| title_full_unstemmed | A two-step surgery and a multidisciplinary approach in a centenarian patient with an acute presentation of right colon cancer |
| title_short | A two-step surgery and a multidisciplinary approach in a centenarian patient with an acute presentation of right colon cancer |
| title_sort | two step surgery and a multidisciplinary approach in a centenarian patient with an acute presentation of right colon cancer |
| topic | Colon cancer Surgery Cecostomy Oldest old Frailty Comprehensive geriatric assessment |
| url | http://link.springer.com/article/10.1186/s12893-020-00708-9 |
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