A Case of Rectal Cancer with Dilated Cardiomyopathy Performed Low-Position Anterior Resection

Masashi Utsumi, Takahiko Tamaki, Toshinori Totsugawa and Takashi Sakakibara

Sakakibara Heart Institude of Okayama

We report a patient with dilated cardiomyopathy who underwent surgery for rectal cancer under general anesthesia despite ejection fraction of 15% (heart hypofunction), and review perioperative management. A 59-year-old man diagnosed with dilated cardiomyopathy who was seen in the Department of Cardiology outpatient clinic was found to have severe anemia and a positive reaction for fecal occult blood, lower digestive tract endoscopy showed a type 2 rectal carcinoma in the Ra rectal region. After conferring with the Departments of Cardiology and Anesthesiology, we conducted low-position anterior resection and D2 lymph node dissection in October 2006. During surgery, we inserted a Swan-Ganz catheter and an invasive arterial pressure line to evaluate circulatory kinetics while monitoring blood pressure, central venous pressure, pulmonary arterial pressure, and urine volume. The man's perioperative course was relatively stable without exacerbation of heart failure or complications. Controlling heart failure to some degree in cooperation with other departments and preparing monitors and agents based on accurate preoperative evaluation thus enabled highly invasive surgery under general anesthesia.

Key words
dilated cardiomyopathy, gastrointestinal surgery, heart hypofunction

Reprint requests
Masashi Utsumi Department of Surgery, Sakakibara Heart Institude of Okayama
2-1-10 Marunouchi, Okayama, 700-0823 JAPAN

Accepted
December 19, 2007

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