Ng Simon S M, Yiu Raymond Y C, Li Jimmy C M, Chan Chi Kwok, Ng Chi Fai, Lau James Y W
Department of Surgery, Chinese University of Hong Kong, Prince of Wales Hospital, Satin, Hong Kong SAR, China.
J Laparoendosc Adv Surg Tech A. 2006 Jun;16(3):297-300. doi: 10.1089/lap.2006.16.297.
Colorectal self-expandable metal stents (SEMS) have been used successfully as preoperative bridges to surgery for obstructive left-sided colorectal carcinoma. Endoscopic relief of the obstruction allows for full bowel preparation and accurate preoperative staging. A laparoscopic approach, considered by many to be contraindicated in the presence of obstruction, becomes feasible after endoscopic decompression. We present a case of obstructive carcinoma of the descending colon successfully treated with endoscopic decompression with colorectal SEMS. Subsequent staging with computed tomography revealed a renal cell carcinoma in the left kidney. Synchronous laparoscopic resection of the two carcinomas was performed, with no morbidity. To the best of our knowledge, this is the first report of endolaparoscopic left hemicolectomy and synchronous laparoscopic radical nephrectomy for obstructive carcinoma of the descending colon and renal cell carcinoma. The advantages of colorectal SEMS and the endolaparoscopic approach in managing obstructive colorectal carcinoma are discussed.
结直肠自膨式金属支架（SEMS）已成功用作左侧结直肠癌梗阻患者术前手术的桥梁。内镜下解除梗阻可实现充分的肠道准备和准确的术前分期。腹腔镜手术在存在梗阻时被许多人认为是禁忌的，但在内镜减压后变得可行。我们报告一例降结肠癌梗阻患者，通过结直肠SEMS进行内镜减压成功治疗。随后的计算机断层扫描分期显示左肾有肾细胞癌。对这两种癌进行了同步腹腔镜切除，无并发症。据我们所知，这是首例关于降结肠癌梗阻合并肾细胞癌行腹腔镜左半结肠切除术及同步腹腔镜根治性肾切除术的报告。文中讨论了结直肠SEMS及腹腔镜手术方法在处理结直肠癌梗阻方面的优势。
