Tan Lincoln Guan Lim, See Ju Yaw, Wong Kutt Sing
Division of Colorectal Surgery, National University Hospital, National University of Singapore, Singapore.
Surg Laparosc Endosc Percutan Tech. 2007 Dec;17(6):551-3. doi: 10.1097/SLE.0b013e31812e55b5.
A 67-year-old woman, with a past medical history of diabetes mellitus and hypertension, underwent an elective laparoscopic anterior resection for sigmoid colon adenocarcinoma. She was readmitted on the tenth postoperative day with complaints of abdominal pain and a foul smelling discharge from her abdominal wound. She was later diagnosed with necrotizing fasciitis (NF) over the extraction wound. To our knowledge there has only been one other case of NF after laparoscopic colonic surgery reported in the literature. We reviewed the literature on NF after laparoscopic surgery, and discussed the clinical diagnosis; diagnostic adjuncts such as magnetic resonance imaging, bedside exploration under local anesthesia, frozen section of deep incisional biopsies, and laboratory tests; and management principles of NF. Although there is a low incidence of wound infections associated with laparoscopic colonic surgery, necrotizing infections although rare, are a very real possibility.
一名67岁女性，有糖尿病和高血压病史，因乙状结肠腺癌接受了择期腹腔镜前切除术。术后第10天因腹痛和腹部伤口有恶臭分泌物再次入院。她后来被诊断为切口处坏死性筋膜炎（NF）。据我们所知，文献中仅报道过1例腹腔镜结肠手术后发生NF的病例。我们回顾了腹腔镜手术后NF的相关文献，并讨论了临床诊断；磁共振成像、局部麻醉下床边探查、深部切口活检冰冻切片及实验室检查等诊断辅助手段；以及NF的处理原则。尽管腹腔镜结肠手术相关伤口感染发生率较低，但坏死性感染虽罕见，却是切实存在的可能性。
