Non-surgical colon cancer treatment for patients with cirrhosis

Only one day after endoscopic dissection of colon tumor on the background of cirrhosis, the patient recovered, ate well and was discharged from the hospital on November 18.

Ms. Bui Thi Mai (73 years old) was re-examined at Tam Anh General Hospital in Hanoi due to cirrhosis of the liver and colon polyps on November 17. Through endoscopy, the doctor found that the transverse colon near the angle of the liver had a leg polyp 15 mm wide, two pedunculated polyps 5-7 mm and many small polyps around. The patient had a 16-year history of cirrhosis, gastrointestinal bleeding, esophageal and gastric varices, and type 2 diabetes for many years.

Doctor, Dr. Vu Truong Khanh, Head of Department of Gastroenterology - Hepatobiliary - Pancreas, said that patients have a high risk of colon cancer in liver polyps that need to be removed early. Patients with a history of coagulopathy should be hospitalized and receive platelet transfusions prior to endoscopic resection of the lesion.

The polyp located in the flexure colon is the angled segment, so the visible area will be narrower. According to Dr. Khanh, this is a position far from the anus, so it can be difficult to observe and perform the doctor's procedure, prone to complications if the skill is not stable. This segment of the colon is still very thin, only a small mistake will cause perforation.

The image of the tumor is marked (left image) and the damaged part is cut, hemostatic clamp helps to heal quickly due to the large cutting area (right image). Photo: Provided by the hospital

Through the assessment of the patient's condition, the doctor's team determined the difficulty of the procedure, thereby mastering the treatment process and avoiding complications. Colonic mucosal dissection ( ESD) was performed in 40 minutes. The flexible bronchoscope has a light with a magnification of more than 100 times to help the doctor easily observe the polyp to be removed. The doctor has removed the whole polyp tumor with the fibrous base.

Through anatomical specimens, large polyps are cancerous tissue originating from the mucosa that has not penetrated deep into the colon. Thanks to the ESD procedure, which detects cancer at an early stage, it helps patients avoid colectomy surgery and does not need chemotherapy. In elderly patients, with cirrhosis , blood clotting factors are reduced, and surgery can be life-threatening.

A doctor of Tam Anh General Hospital performs colonoscopy for a patient. Photo: Provided by the hospital

Dr. Khanh further shared that the complicated and technically difficult mucosal dissection should be performed by a qualified doctor with the support of modern machines. When the early stage tumor has not penetrated deep into the submucosa of the gastrointestinal tract wall, the less invasive method of dissection of the lesion helps people with many underlying diseases and weak health quickly recover and limit complications. , shorten the hospital stay.