A successful case of laparoscopic colorectal cancer resection in an elderly patient with factor XI deficiency
Abstract Background Congenital XI factor deficiency is a rare disease caused by autosomal recessive inheritance. Clinically, there are few spontaneous hemorrhages, which can cause abnormal bleeding after trauma, surgery, and tooth extraction. We experienced a colon cancer patient with congenital XI...
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Japan Surgical Society
2019-05-01
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| Series: | Surgical Case Reports |
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| Online Access: | http://link.springer.com/article/10.1186/s40792-019-0643-4 |
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| author | Hiroka Kondo Yasumitsu Hirano Toshimasa Ishii Kiyoka Hara Shintaro Ishikawa Takuhisa Okada Nao Obara Liming Wang Shigeki Yamaguchi |
| author_facet | Hiroka Kondo Yasumitsu Hirano Toshimasa Ishii Kiyoka Hara Shintaro Ishikawa Takuhisa Okada Nao Obara Liming Wang Shigeki Yamaguchi |
| author_sort | Hiroka Kondo |
| collection | DOAJ |
| description | Abstract Background Congenital XI factor deficiency is a rare disease caused by autosomal recessive inheritance. Clinically, there are few spontaneous hemorrhages, which can cause abnormal bleeding after trauma, surgery, and tooth extraction. We experienced a colon cancer patient with congenital XI factor deficiency who was successfully treated by laparoscopic approach with the administration of the preoperative fresh frozen plasma (FFP). Case presentation The patient was an 82-year-old woman who complained of right lower abdominal pain for a period of 2 months with no previous history of abnormal hemostasis. She received colonoscopy and was diagnosed with ascending colon cancer. Preoperative blood tests resulted in prolongation of activated partial thromboplastin time (APTT). After further investigation, factor XI (FXI) activity was found to be abnormal at 3.0% and congenital FXI deficiency was diagnosed. By replenishing FXI by FFP, APTT was improved to 37 s so perioperative abnormal bleeding could be avoided and an operation for ascending colon cancer performed. The patient received laparoscopic ileocolic resection and was discharged on a postoperative day 7 uneventfully. Conclusion It is important to detect coagulation disorders such as FXI deficiency during routine preoperative checkups, and it is also important to consider unrecognized coagulation disorders if we encounter unexplained abnormal bleeding after surgery or trauma. In patients who have already been diagnosed with FXI deficiency, appropriate treatment including administration of FFP should be considered before surgery, and laparoscopic approach has a possibility to bring safety outcomes as an effect of the reduction of the intraoperative bleeding. |
| format | Article |
| id | doaj-art-e27b24bbb52c44f29e2c4abf8a0105c9 |
| institution | DOAJ |
| issn | 2198-7793 |
| language | English |
| publishDate | 2019-05-01 |
| publisher | Japan Surgical Society |
| record_format | Article |
| series | Surgical Case Reports |
| spelling | doaj-art-e27b24bbb52c44f29e2c4abf8a0105c92025-08-20T02:51:03ZengJapan Surgical SocietySurgical Case Reports2198-77932019-05-01511510.1186/s40792-019-0643-4A successful case of laparoscopic colorectal cancer resection in an elderly patient with factor XI deficiencyHiroka Kondo0Yasumitsu Hirano1Toshimasa Ishii2Kiyoka Hara3Shintaro Ishikawa4Takuhisa Okada5Nao Obara6Liming Wang7Shigeki Yamaguchi8Department of Gastroenterological Surgery, Saitama Medical University International Medical CenterDepartment of Gastroenterological Surgery, Saitama Medical University International Medical CenterDepartment of Gastroenterological Surgery, Saitama Medical University International Medical CenterDepartment of Gastroenterological Surgery, Saitama Medical University International Medical CenterDepartment of Gastroenterological Surgery, Saitama Medical University International Medical CenterDepartment of Gastroenterological Surgery, Saitama Medical University International Medical CenterDepartment of Gastroenterological Surgery, Saitama Medical University International Medical CenterDepartment of Gastroenterological Surgery, Saitama Medical University International Medical CenterDepartment of Gastroenterological Surgery, Saitama Medical University International Medical CenterAbstract Background Congenital XI factor deficiency is a rare disease caused by autosomal recessive inheritance. Clinically, there are few spontaneous hemorrhages, which can cause abnormal bleeding after trauma, surgery, and tooth extraction. We experienced a colon cancer patient with congenital XI factor deficiency who was successfully treated by laparoscopic approach with the administration of the preoperative fresh frozen plasma (FFP). Case presentation The patient was an 82-year-old woman who complained of right lower abdominal pain for a period of 2 months with no previous history of abnormal hemostasis. She received colonoscopy and was diagnosed with ascending colon cancer. Preoperative blood tests resulted in prolongation of activated partial thromboplastin time (APTT). After further investigation, factor XI (FXI) activity was found to be abnormal at 3.0% and congenital FXI deficiency was diagnosed. By replenishing FXI by FFP, APTT was improved to 37 s so perioperative abnormal bleeding could be avoided and an operation for ascending colon cancer performed. The patient received laparoscopic ileocolic resection and was discharged on a postoperative day 7 uneventfully. Conclusion It is important to detect coagulation disorders such as FXI deficiency during routine preoperative checkups, and it is also important to consider unrecognized coagulation disorders if we encounter unexplained abnormal bleeding after surgery or trauma. In patients who have already been diagnosed with FXI deficiency, appropriate treatment including administration of FFP should be considered before surgery, and laparoscopic approach has a possibility to bring safety outcomes as an effect of the reduction of the intraoperative bleeding.http://link.springer.com/article/10.1186/s40792-019-0643-4Factor XI deficiencyFresh frozen plasmaColon cancer |
| spellingShingle | Hiroka Kondo Yasumitsu Hirano Toshimasa Ishii Kiyoka Hara Shintaro Ishikawa Takuhisa Okada Nao Obara Liming Wang Shigeki Yamaguchi A successful case of laparoscopic colorectal cancer resection in an elderly patient with factor XI deficiency Surgical Case Reports Factor XI deficiency Fresh frozen plasma Colon cancer |
| title | A successful case of laparoscopic colorectal cancer resection in an elderly patient with factor XI deficiency |
| title_full | A successful case of laparoscopic colorectal cancer resection in an elderly patient with factor XI deficiency |
| title_fullStr | A successful case of laparoscopic colorectal cancer resection in an elderly patient with factor XI deficiency |
| title_full_unstemmed | A successful case of laparoscopic colorectal cancer resection in an elderly patient with factor XI deficiency |
| title_short | A successful case of laparoscopic colorectal cancer resection in an elderly patient with factor XI deficiency |
| title_sort | successful case of laparoscopic colorectal cancer resection in an elderly patient with factor xi deficiency |
| topic | Factor XI deficiency Fresh frozen plasma Colon cancer |
| url | http://link.springer.com/article/10.1186/s40792-019-0643-4 |
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