Our Summary

The research paper discusses a rare blood vessel condition called pelvic arteriovenous malformation (AVM), which complicates treatment decisions when a patient also has colon cancer. The paper presents a case where a 77-year-old man was diagnosed with this condition along with colon cancer. The doctors first treated the AVM by blocking the blood flow to it (a procedure called embolization), which made it shrink. After confirming the shrinkage through a CT scan, the doctors performed a minimally invasive surgery to remove the affected part of the colon. The patient recovered without any complications. This suggests that for patients with both these conditions, treating the AVM first may help in safely performing minimally invasive surgery for colon cancer.

FAQs

  1. What is a pelvic arteriovenous malformation (AVM) and how does it relate to colon cancer?
  2. How is interventional radiology used in the treatment of colon cancer patients with pelvic AVM?
  3. What is the purpose of preoperative pelvic AVM embolization in patients with sigmoid colon cancer?

Doctor’s Tip

A helpful tip a doctor might tell a patient about sigmoidectomy is to follow all preoperative instructions carefully, including any dietary restrictions or bowel preparation. This will help ensure a successful surgery and smooth recovery. Additionally, it is important to communicate any concerns or questions with your healthcare team before and after the procedure.

Suitable For

Patients who are typically recommended sigmoidectomy are those with sigmoid colon cancer, particularly if they have concurrent pelvic arteriovenous malformation. This may include patients with symptoms such as fatigue, thickening of the sigmoid colon wall on imaging, and irregularly dilated pelvic blood vessels. In these cases, preoperative transcatheter embolization of the AVM may be performed to shrink the AVM and facilitate safe laparoscopic sigmoidectomy. This approach allows for minimally invasive surgery and can help prevent complications during and after the procedure.

Timeline

Before sigmoidectomy:

  • Patient presents with symptoms such as fatigue.
  • Computed tomography reveals thickening of the sigmoid colon wall and irregularly dilated pelvic blood vessels.
  • Preoperative transcatheter embolization of the pelvic arteriovenous malformation (AVM) is performed.

After sigmoidectomy:

  • Laparoscopic sigmoidectomy is performed without complications.
  • Confirmation of AVM shrinkage via computed tomography.
  • Patient is discharged without complications.

What to Ask Your Doctor

  1. What is a sigmoidectomy and why is it recommended for my condition?
  2. How will the preoperative pelvic arteriovenous malformation (AVM) embolization benefit me before the surgery?
  3. What are the potential risks and complications associated with the sigmoidectomy procedure?
  4. How long is the recovery period after a sigmoidectomy?
  5. Will I need any additional treatments or follow-up care after the surgery?
  6. How will the presence of the pelvic AVM affect my colon cancer treatment and prognosis?
  7. Are there any lifestyle changes or dietary recommendations I should follow after the surgery?
  8. What will be the long-term implications of having both a sigmoidectomy and preoperative AVM embolization?
  9. Will I need any additional imaging or tests to monitor the AVM after the surgery?
  10. Are there any alternative treatment options for my condition, and if so, what are the pros and cons of each option?

Reference

Authors: Inaguma G, Otsuka K, Masumori K, Hiro J, Kumamoto T, Kamishima M, Kobayashi Y, Chong Y, Omura Y, Taniguchi H, Tsujimura K, Chikaishi Y, Tsurumachi A, Akamatsu H, Uyama I, Suda K. Journal: Asian J Endosc Surg. 2025 Jan-Dec;18(1):e70037. doi: 10.1111/ases.70037. PMID: 39978930