Simultaneous surgical management of colon neoplasia and giant ventral hernia

Abstract

Introduction:

Although the simultaneous treatment of abdominal wall defects associated with visceral surgery (cholecystectomy, intestinal resection, Hartmann reconstruction) has been described, however, the simultaneous treatment of a colon neoplasm associated with complex abdominal wall defect has not been documented.

Case report:

We present the case of a 64-year-old woman, with morbid obesity and two long-standing hernias,  who was diagnosed with Colon neoplasia.

After the multidisciplinary evaluation of the case, we started with optimization of patient´s comorbidities. Because of complexity of the hernia pathology, we performed preoperatively preparation with: Botulinum toxin in the abdominal wall and preoperative progressive pneumoperitoneum.

Subsequently, surgical intervention performed was sigmoidectomy and polypropylene mesh repair of the abdominal wall defect.

The postoperative course was uneventful and was discharged on the 7th postoperative day. 48 hours after discharge, he returned to the emergency department due to fever that was attributed to a subcutaneous seroma infection that was treated with antibiotics.

Pathological assessment of surgical specimen was Adenocarcinoma, intestinal type, moderately differentiated, pT2 N0 (0/21), no signs of poor prognosis.

Currently, the patient is free of neoplastic disease and without hernia recurrence.