Jimi Sei-ichiro, Hotokezaka Masayuki, Eto Tada-aki, Hidaka Hideki, Maehara Naoki, Matsumoto Kotaro, Chijiiwa Kazuo
Department of Surgery 1, Miyazaki University School of Medicine, Miyazaki, Japan.
Surg Laparosc Endosc Percutan Tech. 2007 Aug;17(4):339-41. doi: 10.1097/SLE.0b013e31806bf493.
We discuss a rare complication in a patient who underwent laparoscopic colectomy. A 69-year-old woman underwent laparoscopy-assisted right colectomy for cancer of the ascending colon. Two months after the operation, bowel obstruction developed. Decompression with a long intestinal tube failed to resolve the obstruction. Thus, surgery was performed. Abdominal exploration revealed a strangulated ileal loop caused by herniation through the mesenteric opening at the anastomotic site. The mesenterium had not been sutured during the previous operation. The anastomotic segment had twisted semicircularly and adhered to the retroperitoneum, so the mesenteric opening had narrowed.
我们讨论了一例接受腹腔镜结肠切除术患者的罕见并发症。一名69岁女性因升结肠癌接受了腹腔镜辅助右半结肠切除术。术后两个月，出现了肠梗阻。使用长肠管减压未能解除梗阻。因此，进行了手术。腹部探查发现一个绞窄性回肠袢，是通过吻合部位的肠系膜开口疝出所致。上一次手术时肠系膜未缝合。吻合段呈半圆形扭转并与腹膜后粘连，因此肠系膜开口变窄。
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