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Cir Cir ; 87(S1): 28-32, 2019.
Article in English | MEDLINE | ID: mdl-31501620

ABSTRACT

BACKGROUND: The successful performance of ostomies for the treatment of different diseases has been described since 1706. We report herein the first case of successful ostomy utilizing a synthetic stoma created in a patient with peritoneal carcinomatosis. CLINICAL CASE: A 40-year-old woman presented with abdominal carcinomatosis due to psammomatous papillotubular adenocarcinoma consistent with primary ovarian carcinoma. The patient had negative estrogen and progesterone receptors and Ki-67 proliferative activity was 83%. She was initially treated with cytoreduction therapy, chemotherapy, and hyperthermic intraperitoneal chemotherapy. Because the patient presented with enteric perforations and the extensive tumor invasion and adhesions in all the intestinal segments made it impossible to create autologous decompression stomas, a synthetic stoma was constructed. CONCLUSIONS: Synthetic stomas can be a good treatment option when autologous stomas can not be created.


INTRODUCCIÓN: Desde el año 1706 se han descrito ostomías realizadas con éxito para el tratamiento de diferentes enfermedades; los autores describen el primer caso de éxito en una ostomía sintética en la carcinomatosis peritoneal. CASO CLÍNICO: Mujer de 40 años de edad con carcinomatosis abdominal por adenocarcinoma papilar tubulopapilar psamomatoso más consistente con cáncer primario de ovario, negativo a receptores de estrógenos y progesterona, con marcador Ki-67 al 83% de actividad. De modo inicial se trató con cirugía de citorreducción, quimioterapia, quimioterapia intraperitoneal hipertérmica y por último realización de estomas sintéticos debido a perforaciones entéricas e imposibilidad de realizar estomas descompresivos autólogos por la invasión tumoral extensa y adherencias de todas las asas intestinales. CONCLUSIONES: Los estomas sintéticos pueden ser una buena opción terapéutica cuando es imposible realizar estomas autólogos.


Subject(s)
Adenocarcinoma, Papillary/secondary , Drainage/instrumentation , Intestinal Neoplasms/secondary , Intestinal Perforation/surgery , Ovarian Neoplasms/surgery , Surgical Stomas , Adenocarcinoma, Papillary/drug therapy , Adenocarcinoma, Papillary/etiology , Adenocarcinoma, Papillary/surgery , Adult , Antineoplastic Combined Chemotherapy Protocols/administration & dosage , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Argon Plasma Coagulation , Bevacizumab/administration & dosage , Carboplatin/administration & dosage , Combined Modality Therapy , Cytoreduction Surgical Procedures/methods , Docetaxel/administration & dosage , Doxorubicin/administration & dosage , Doxorubicin/analogs & derivatives , Fatal Outcome , Female , Humans , Hyperthermia, Induced , Intestinal Neoplasms/drug therapy , Intestinal Neoplasms/etiology , Intestinal Neoplasms/surgery , Intestinal Perforation/etiology , Mitomycin/administration & dosage , Polyethylene Glycols/administration & dosage
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