DOI: 10.36347/sjmcr.2018.v06i11.012

Pages: 944-954

This citation is about an interesting synchronous multiple primary colorectal cancer with severe co-morbidities like severe restrictive airway disease which led to pulmonologists and anesthetists declaring him as very high anesthetic risk case. Pulmonologists had even professed that he will require lifelong noninvasive ventilatory support such as C-PAP or Bi PAP. In addition, patient had extensive cerebral infarct in the right high frontal region with extension along the cortico-spinal tract with Wallarian degeneration. He also had a 3 cm lobulated cystic mass in the right thalamus either due to? Inflammatory? infective? Neoplastic etiology. To add on to the woo, patient vehemently refused to have colostomy. Considering his poor respiratory function and the absolute necessity to perform total colectomy, a very major surgical ordeal, oncologists gave a dismal prognosis not because of the malignancy but because of the severe co-morbidities. Also they declared that he must accept permanent ileostomy, for there is no other alternative according to protocols. Given a bleak prognosis and a stern compulsion for permanent ileostomy, patient walked out of the corporate hospitals in Bangalore, saying in disgust that he preferred dying than having colostomy/Ileostomy. Such a complex problematic case was given an excellent clinical recovery, of course without colostomy, wiping out both the cancers in the colon and relieving him of his respiratory distress with a combination of conventional Right Hemi colectomy for his ascending colon cancer and an innovative unique first of its kind treatment strategy with CRYOFREEZING as the main tool to deal with the anorectal growth and his restrictive airway disease decisively.