Elective staged proctocolectomy and living donor liver transplantation for colon cancer with sclerosing cholangitis-related ulcerative colitis: a case report

Surgical Case Reports

Tatsuya Kinjo¹  Yoshihiro Miyagi¹  Mitsuhisa Takatsuki¹  Tetsu Kinjo²  Shingo Arakaki²  Akira Hokama²  Tomoharu Yoshizumi³  Noboru Harada³ 

[1] Department of Digestive and General Surgery, Graduate School of Medicine, University of the Ryukyus, 207 Uehara, 903-0125, Nishihara, Okinawa, Japan;Department of Infectious, Respiratory, and Digestive Medicine, University of the Ryukyus, Okinawa, Japan;Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan;

关键词: Colitis-related colon cancer;    Ileal pouch–anal anastomosis;    Inflammatory bowel disease;    Small-for-size syndrome;   

DOI  :  10.1186/s40792-020-01059-6

来源: Springer

【 摘 要 】

BackgroundPrimary sclerosing cholangitis (PSC) is a well-known complication of ulcerative colitis (UC), but it is rare to encounter patients requiring both living donor liver transplantation (LDLT) and proctocolectomy. We report a case of elective two-stage surgery involving proctocolectomy performed after LDLT for a patient with early colon cancer concurrent with PSC-related UC. To our knowledge, this is the first report of concurrent cancer successfully treated with both LDLT and proctocolectomy.Case presentationA 32-year-old Japanese man with colon cancer associated with UC underwent restorative proctocolectomy at 3 months after living donor liver transplantation (LDLT) for PSC. He was diagnosed with PSC and UC when he was a teenager. Conservative therapy was initiated to treat both PSC and UC. He had experienced recurrent cholangitis for years; therefore, a biliary stent was placed endoscopically. However, his liver function progressively deteriorated. Colonoscopic surveillance revealed early colon cancer; hence, surgical treatment was considered. PSC progressed to cirrhosis and portal hypertension; hence, LDLT was performed before restorative proctocolectomy. Three months after LDLT, we performed restorative proctocolectomy with ileal pouch–anal anastomosis. The postoperative course was uneventful. The patient was well, with good liver and bowel functions and without tumor recurrence, more than 1 year after proctocolectomy.ConclusionsWith strict patient selection and careful patient management and follow-up, elective proctocolectomy may be performed safely and effectively after LDLT for concurrent early colon cancer with PSC-related UC. There are no previous reports of the use of both LDLT and proctocolectomy for the successful treatment of PSC-related UC and concurrent cancer.

【 授权许可】

CC BY