polidocanol and Rectal-Neoplasms

Bleeding of parastomal varices is an unusual complication of portal hypertension. We report a case with recurrent parastomal variceal bleeding who had chronic liver disease secondary to autoimmune hepatitis and who had undergone abdominoperineal resection for rectal cancer. She presented four episodes of parastomal variceal bleeding in one month and was successfully treated with combined polidocanol and cyanoacrylate glue.

Topics: Colostomy; Cyanoacrylates; End Stage Liver Disease; Female; Hepatitis, Autoimmune; Humans; Polidocanol; Polyethylene Glycols; Rectal Neoplasms; Recurrence; Tissue Adhesives; Varicose Veins

Between January 1987 and December 1988, at the Surgical Department of Chiarenzi Hospital, five patients underwent endoscopic intratumoral injection of polidocanol for palliative treatment of inoperable carcinoma of the rectum. Histological evaluation was performed in all cases. The patients comprised two males and three females aged 78 to 88 years (mean 83.4). One of them refused surgery for recurrent rectal cancer, four consulted us with impending intestinal obstruction; three were inoperable due to local spread of the tumor and poor general condition, the other was in a poor general condition due to massive metastatic hepatic disease. In all the patients, we observed remission of the obstructive symptoms with no major complications; none of them has required a colostomy. The follow-up period has covered a period of two months to two years. The technique of injection is simple, inexpensive and, properly performed, safe. All these advantages make this type of palliative treatment for rectal cancer interesting, even when compared with laser treatment, urological resectoscope or electric snare resection, and electrocoagulation.

Topics: Adenocarcinoma; Aged; Aged, 80 and over; Colonoscopy; Female; Humans; Male; Palliative Care; Polidocanol; Polyethylene Glycols; Rectal Neoplasms; Sclerosing Solutions; Sclerotherapy

Topics: Aged; Colon; Colostomy; Gastrointestinal Hemorrhage; Humans; Hypertension, Portal; Male; Polidocanol; Polyethylene Glycols; Postoperative Complications; Rectal Neoplasms; Sclerosing Solutions; Varicose Veins