Chiu Chong-Chi, Wei Po-Li, Huang Ming-Te, Wang Weu, Chen Tai-Chi, Lee Wei-Jei
Division of General Surgery, Department of Surgery, Chi-Mei Hospital, PO Box 174. Shan Hua, Liouying, Tainan County 741, Taiwan.
J Laparoendosc Adv Surg Tech A. 2006 Feb;16(1):37-40. doi: 10.1089/lap.2006.16.37.
We report the case of a 51-year-old man who had abdominal distension and intermittent cramping pain for 4 months. A lower gastrointestinal double-contrast study revealed a protruding mass at the transverse colon. Endoscopic ultrasonography showed a lesion arising from the submucosal layer. Instead of a laparotomy, the lesion was removed laparoscopically with the assistance of a colonoscope. No operative morbidity was noted. With future improvements of this technique, tumors that are difficult to remove with colonoscopy can be excised laparoscopically without the aid of an endoscopic stapler. In our case, the tumor was localized intraoperatively and extracted using the intraoperative colonoscopy. This double-scope technique is safe and cost-effective for some difficult colonic lesions.
我们报告了一例51岁男性患者,其腹胀和间歇性绞痛已持续4个月。下消化道双重对比造影检查显示横结肠有一突出肿物。内镜超声检查显示病变起源于黏膜下层。该病变未进行剖腹手术,而是在结肠镜辅助下通过腹腔镜切除。未发现手术相关并发症。随着该技术未来的改进,难以通过结肠镜切除的肿瘤可在无内镜吻合器辅助的情况下通过腹腔镜切除。在我们的病例中,肿瘤在术中定位,并通过术中结肠镜取出。这种双镜技术对于一些困难的结肠病变是安全且具有成本效益的。