Furuhata Tomohisa, Hata Fumitake, Kihara Chikashi, Tsurum Tetsuhiro, Okita Kenji, Nomura Hiroki, Kimura Yasutoshi, Katsuramaki Tadashi, Mukaiya Mitsuhiro, Sasaki Kazuaki, Hirata Koichi
First Department of Surgery, Sapporo Medical University, School of Medicine, Chuo-ku, Sapporo 060-8543, Japan.
Int Surg. 2007 Sep-Oct;92(5):262-5.
We report herein a case of a 64-year-old woman found to have anastomotic suture line recurrence of an early rectal carcinoma. The patient had undergone laparoscopy-assisted low anterior rectal resection for an early rectal carcinoma 2 years before the anastomotic site recurrence. A follow-up colonoscopy revealed an elevated lesion on the anastomotic suture line. The diagnosis of adenocarcinoma was confirmed by biopsy. The patient underwent a resection of the remnant rectum. Histological examination of the resected specimen showed that the anastomotic site recurrence might have been caused by intraluminal implantation from the primary rectal cancer. We speculate that intraluminal implantation might be caused by insufficient intraoperative rectal irrigation because of limited access often encountered in laparoscopic surgery. We propose that it is necessary to devise a method with which to perform sufficient intraoperative rectal irrigation in laparoscopic surgery for rectal carcinoma.
我们在此报告一例64岁女性，其被发现患有早期直肠癌吻合口缝线处复发。该患者在吻合口复发前2年因早期直肠癌接受了腹腔镜辅助低位前直肠切除术。后续结肠镜检查显示吻合口缝线上有一个隆起病变。活检确诊为腺癌。该患者接受了残余直肠切除术。切除标本的组织学检查表明，吻合口复发可能是由原发性直肠癌的腔内种植引起的。我们推测腔内种植可能是由于腹腔镜手术中常遇到的手术入路受限导致术中直肠冲洗不足所致。我们建议有必要设计一种方法，以便在腹腔镜直肠癌手术中进行充分的术中直肠冲洗。
