[Malignant small bowel ileus caused by local recurrence after colorectal cancer surgery]

We assessed 5 consecutive patients operated for local recurrence of small bowel obstruction after previous operation for colorectal cancer. Case 1 involved a 71-year-old man who presented with local recurrence with invasion of the ileum after low anterior resection( D3) for rectal cancer( Rb[rectum/below the peritoneal reflection]). Case 2 involved a 51-year-old woman; case 3, a 54-year-old woman; and case 4, a 60-year-old woman, all showing local recurrence with invasion of the jejunum and ureter after high anterior resection (D3) for rectal cancer (Ra[rectum/above the peritoneal reflection]). Case 5 involved a 58-year-old man who showed local recurrence of descending colon cancer with invasion of the jejunum, liver metastasis, and brain metastasis after left hemicolectomy( D3) for descending colon cancer. For the treatment of local recurrence in the patient referred to in case 1, amputation recti with partial resection of the ileum was performed. Partial resection of the ileum was performed in the patients referred to in cases 2 and 3. Nephrostomy was performed in patients referred to in cases 2, 3, and 4. Partial resection of the anastomotic colon and jejunum was performed in the patient referred to in case 5. The patient involved in case 5 underwent radiotherapy for brain metastasis. In the patient referred to in case 1, only radical surgery was performed, which is associated with a good prognosis. The estimated survival after the operation for local recurrence, except for the patient referred to in case 1, was 2 to 15 months( mean, 11.5 months). Oral intake periods, except for the patient referred to in case 1, were 0 to 4 months (mean, 2.3 months). Postoperative complication rates were 80%( 4/5). Our findings suggest that radical operation leads to a good quality of life( QOL) in patients with malignant small bowel obstruction.