A CASE OF PRIMARY MULTIPLE COLORECTAL CANCER IN THE BACKGROUND OF DIFFUSE COLON POLYPOSIS

Diffuse polyposis of the colon is a genetically determined disease that affects young people, inherited according to the principle of autosomal dominance with an 80 % degree of penetration of the APC gene and an almost 100 % malignancy index. 

Total coloproctectomy is the only radical method of treating diffuse colon polyposis, which leads to disability of the patient and is accompanied by impaired sexual and reproductive function. Total colectomy provides better functional results, but the remaining portion of the rectum can become a source of recurrence of polyps and lead to the development of rectal cancer.

Laparoscopic coloproctectomy is a modern method of treating diffuse colon polyposis that meets the requirements of early rehabilitation of patients, has optimal functional results while maintaining oncological principles of radicalism by removing malignant tumors.

This article reflects our unique experience of performing laparoscopic coloproctectomy with D3 lymphodissection in a patient with multiple primary colorectal cancer in the background of diffuse colon polyposis. The use of laparoscopic techniques provided the opportunity for early rapid rehabilitation (the patient was discharged on the 13th day in satisfactory condition) with subsequent good functional, psycho-emotional and social results when assessing the quality of life using the SF-36 questionnaire. At the same time, all the principles of oncological radicalism are observed, including the non-routine performance of D3 lymphodissection. Based on the results of histological and moleculargenetic studies, a decision was made to carry out chemotherapy in CapeOx regimen. During the control CT study and determination of the level of tumor markers six months after the operation, no evidence of progression was obtained.

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