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Surgical strategy in an elderly and fragile patient with synchronous colonic lesions
Posted in Debates on 19 July 2016

A 87-year-old female patient with a previous history of high blood pressure, stage 4 chronic renal failure and a cholecystectomy by open approach. Due to anemia she underwent a colonoscopy that revealed a stenotic lesion 20 cm from the anal verge. A biopsy revealed a moderately differentiated adenocarcinoma, immunohistochemistry of mismatch repair genes was normal. As the colonoscopy was incomplete a colono CT Scan was performed, and no distant metastasis was found. Three additional synchronic lesions were described (2.6 cm sessile polyp in the descending colon, 8mm polyp in the ascending colon and a 1.7 cm sessile polyp below the ileocecal valve). This is an ASA score III patient. Which therapeutic approach should be followed?

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