Rectal cancer in pregnancy: a new management based on blended anesthesia and monitoring of fetal well being

Colorectal carcinoma presenting during pregnancy is an extremely rare condi tion associated with a poor prognosis. In this report we studied a patient referred to our hospital at 26 weeks of gestation with the diagnosis of rec tal adenocarcinoma, Tumor resection with a colostomy was planned in the att empt to preserve pregnancy until fetal viability could be reached. Blended anesthesia (general and epidural) was chosen to avoid surgical and anesthes iological risks; in fact this technique allows either an optimal block of n eurohormonal response or a good control of surgical stress to be obtained. In order to monitor fetal well being during surgery, Doppler evaluations of fetal heart rate and umbilical artery flow velocity waveforms were perform ed. The patient was dismissed in good health and then rehospitalized at 32 weeks of gestation in order to perform an elective cesarean section. In con clusion we suggest that, with the choice of a good anesthesiological techni que and monitoring of fetal well being, surgical treatment in case of recta l cancer could be performed without affecting the course of pregnancy. (C) 2000 Published by Elsevier science Ireland Ltd. All rights reserved.