Ana-Maria Mihai1, M. Alecu2, L. Simion2, N.D. Straja2

1“Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
2Surgical Clinic I, “Professor Doctor Alexandru Trestioreanu” Institute of Oncology, Bucharest, Romania

Corresponding author: Ana-Maria Mihai
Phone no. 0040752542906
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In spite of a correct surgical technique, colon interventions can lead to complications of the fistula, sometimes real abdominal dramas, worsening the prognosis of these patients and hardening the surgical technique. We present the evolution of a patient initially treated endoscopically for a sigmoid polyp. The histopathological examination of the biopsy confirmed its malignant character, with invasion of the pedicle, for which reason the endoscopic polypectomy is considered insufficient from an oncological point of view and a colonic resection is advisable. In the postoperative evolution of the patient there appear complications through the occurrence of an anastomotic fistula and peritonitis, whose presence leads to the necessity of performing a terminal colostomy which permits the cessation of the inflammatory syndrome. The further reinstatement of transit is done by means of an “a minima” cecostomy, thus reducing the clinical impact in case of other complications of the fistula. The following elements were analyzed: the patient’s history, associated diseases, fistula-related risk factors, biochemical, imaging and clinical samples, elements related to the surgical technique and the entire postoperative evolution of the patient. This paper stands as an argument in supporting the advantages of “a minima” cesostomy in case of colon surgery, proving how a technical artifice which is minimally invasive for the patient and easy to achieve may become very useful in solving or even preventing some severe complications arising on the background of a simple pathology.

Keywords: polyp, colonic cancer, fistula, cecostomy

Wednesday the 21st.