Severity: Warning
Message: file_get_contents(https://...@pubfacts.com&api_key=b8daa3ad693db53b1410957c26c9a51b4908&a=1): Failed to open stream: HTTP request failed! HTTP/1.1 429 Too Many Requests
Filename: helpers/my_audit_helper.php
Line Number: 176
Backtrace:
File: /var/www/html/application/helpers/my_audit_helper.php
Line: 176
Function: file_get_contents
File: /var/www/html/application/helpers/my_audit_helper.php
Line: 250
Function: simplexml_load_file_from_url
File: /var/www/html/application/helpers/my_audit_helper.php
Line: 1034
Function: getPubMedXML
File: /var/www/html/application/helpers/my_audit_helper.php
Line: 3152
Function: GetPubMedArticleOutput_2016
File: /var/www/html/application/controllers/Detail.php
Line: 575
Function: pubMedSearch_Global
File: /var/www/html/application/controllers/Detail.php
Line: 489
Function: pubMedGetRelatedKeyword
File: /var/www/html/index.php
Line: 316
Function: require_once
An 89-year-old woman underwent low anterior resection for rectal adenocarcinoma(Ra, pT3N0M0, pStage II , Cur A)in 2008. In February 2016, she underwent an outpatient examination because of a defecation disturbance. Lower gastrointestinal endoscopy was performed and the stenotic region was biopsied. However, no malignancy was detected and the stenotic site expanded. However, the patient experienced recurrence of the same symptoms, developed severe anal stenosis, and underwent another examination in December 2016. Magnetic resonance imaging indicated a neoplastic lesion around the entire circumference of the anal canal. Transperineal needle biopsy results indicated squamous cell carcinoma. The patient was diagnosed with postoperative rectal cancer and metachronous anal canal squamous cell carcinoma(P, cT4bN2M0, cStage III b). Laparoscopic artificial anus construction was performed with the aim of unblocking the anal canal stenosis. Considering the patient's age and performance status, radiation therapy was administered. Two months after administering radiation therapy, the tumor decreased in size, and anal pain reduced.
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