Our Summary

A 75-year-old man who previously had stomach and colon cancer surgeries had successful treatment for pancreatic cancer, a tricky procedure due to his complicated medical history. This patient’s pancreatic cancer was caught early, and did not spread to his lymph nodes. He was given two rounds of chemotherapy before the operation, which didn’t reduce the tumor size but revealed a blood flow issue to his colon due to artery narrowing caused by hardened arteries.

To address this, a stent (a small tube to keep the artery open) was placed in the artery the day before surgery. The surgeons then performed a complex operation to remove the pancreatic tumor while keeping the blood supply to the stomach intact. This was done by preserving certain blood vessels during the procedure. After surgery, the doctors confirmed that the blood supply to the stomach was good. The operation took almost eight hours, and the patient lost a moderate amount of blood.

The tumor was confirmed to be a moderately aggressive form of pancreatic cancer. After the surgery, the patient recovered well and was sent home on the 23rd day. He began more chemotherapy about two months after the operation and has been cancer-free for seven months. This successful treatment shows that complex pancreatic surgery can be safely performed in patients with significant pre-existing conditions, by careful pre-operative planning, surgical technique, and post-operative care.

FAQs

  1. What measures were taken to preserve the patient’s blood flow to the stomach during the pancreatic cancer surgery?
  2. How was the patient’s blood flow issue to his colon addressed prior to the pancreatic cancer surgery?
  3. After the patient’s successful pancreatic cancer surgery, what was his recovery process like and what further treatments did he undergo?

Doctor’s Tip

A helpful tip a doctor might tell a patient about sigmoidectomy is to follow post-operative care instructions carefully to ensure proper healing and reduce the risk of complications. This may include taking prescribed medications, eating a healthy diet, avoiding strenuous activities, and attending follow-up appointments with your healthcare team. It is also important to communicate any concerns or changes in symptoms to your doctor promptly.

Suitable For

Patients who are typically recommended sigmoidectomy are those with conditions such as:

  • Colon cancer
  • Diverticulitis
  • Inflammatory bowel disease
  • Severe constipation or obstruction in the sigmoid colon

In the case of the 75-year-old man with pancreatic cancer, his surgery was focused on the pancreas and blood supply to the stomach, rather than the sigmoid colon. However, patients with similar complex medical histories may also undergo sigmoidectomy if they have additional conditions affecting the sigmoid colon.

Timeline

  • Before sigmoidectomy:
  1. Patient diagnosed with pancreatic cancer and undergoes two rounds of chemotherapy.
  2. Stent placed in artery to address blood flow issue to colon caused by artery narrowing.
  3. Complex surgery performed to remove pancreatic tumor while preserving blood supply to stomach.
  4. Surgery lasts almost eight hours and patient loses moderate amount of blood.
  5. Tumor confirmed to be moderately aggressive form of pancreatic cancer.
  • After sigmoidectomy:
  1. Patient recovers well and is discharged on the 23rd day after surgery.
  2. Patient begins more chemotherapy about two months after surgery.
  3. Patient remains cancer-free for seven months, showing successful treatment.

What to Ask Your Doctor

  1. What is a sigmoidectomy and why is it necessary for my condition?
  2. What are the potential risks and complications associated with sigmoidectomy?
  3. How will the surgery be performed and what can I expect during the recovery process?
  4. Will I need any additional treatments or medications after the surgery?
  5. How will this surgery impact my quality of life and daily activities?
  6. Are there any long-term effects or considerations I should be aware of?
  7. How often will I need follow-up appointments and monitoring after the surgery?
  8. What are the chances of the cancer returning and what steps can be taken to prevent recurrence?
  9. Are there any lifestyle changes or dietary recommendations I should follow post-surgery?
  10. What support resources are available for me and my family during this process?

Reference

Authors: Nakane Y, Minami T, Kurumiya Y, Mizuno K, Sekoguchi E, Sugawara G, Inoue M, Kato T, Akita N. Journal: Surg Case Rep. 2024 Nov 21;10(1):266. doi: 10.1186/s40792-024-02063-w. PMID: 39570502