Multiple bowel perforations on bevacizumab therapy. review of the literature and clinical case
https://doi.org/10.17238/2072-3180-2022-3-66-73
Abstract
Introduction. Biological agents such as bevacizumab with anti-VEGF (vascular endothelial growth factor) alone or in conjunction with chemotherapy increase the risk of bowel perforation. The eLibrary query "bevacizumab" received 202 publications, but no reports of bowel perforation during treatment with this drug were found.
Clinical case. Here is a clinical case of surgical treatment of a patient with tumor perforation of the transverse colon, recurrent perforations of the duodenum and jejunum on the background of bevacizumab therapy.
Discussion. Bowel perforation due to tumor necrosis and direct damaging effects on the intestinal wall is indicated as a possible complication of bevacizumab therapy. Kidney-cell and generalized colorectal cancer, unresectable primary tumor, therapy with high doses of bevacizumab (5 mg/kg), colonoscopy within 1 month after initiation of therapy, and prior radiation therapy are risk factors for perforation.
Conclusions The results of surgery and nonoperative treatment of gastrointestinal perforations against the background of bevacizumab therapy are considered.
About the Authors
A. E. Tyagynov
Pirogov Russian National Research Medical University (Pirogov Medical University)
Russian Federation
Russian Federation
Tyagunov Alexander Evgenievich – Doctor of Medical Sciences, Professor
117997, Ostrovityanova st. 1, Moscow
I. V. Ermakov
Pirogov Russian National Research Medical University (Pirogov Medical University)
Russian Federation
Russian Federation
Ermakov Igor Viktorovich – Candidate of Medical Sciences, Assistant
117997, Ostrovityanova st. 1, Moscow
A. V. Tavadov
City Clinical Hospital № 40 (Kommunarka) of the Moscow Department of Health
Russian Federation
Russian Federation
Tavadov Arsen Vladislavovich – Candidate of Medical Sciences, Surgeon
142770, 8 Sosensky St., Moscow
I. I. Kutsenko
City Clinical Hospital № 40 (Kommunarka) of the Moscow Department of Health
Russian Federation
Russian Federation
Kutsenko Ivan Ivanovich – Surgeon
142770, 8 Sosensky St., Moscow
G. I. Kurbanov
Pirogov Russian National Research Medical University (Pirogov Medical University)
Russian Federation
Russian Federation
Kurbanov Gusen Ilyasovich – Surgeon resident
117997, Ostrovityanova st. 1, Moscow
A. V. Sazhin
Pirogov Russian National Research Medical University (Pirogov Medical University)
Russian Federation
Russian Federation
Sazhin Alexander Vyacheslavovich – Doctor of Medical Sciences, Professor, head of department
117997, Ostrovityanova st. 1, Moscow
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For citations:
Tyagynov A.E., Ermakov I.V., Tavadov A.V., Kutsenko I.I., Kurbanov G.I., Sazhin A.V. Multiple bowel perforations on bevacizumab therapy. review of the literature and clinical case. Moscow Surgical Journal. 2022;(3):66-73. (In Russ.) https://doi.org/10.17238/2072-3180-2022-3-66-73
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