Mukai Masaya, Kishima Kyoko, Iizuka Shin-Ichi, Fukumitsu Hiroshi, Fukasawa Maki, Yazawa Naoki, Tajima Takayuki, Nakamura Masato, Makuuchi Hiroyasu
Department of Surgery, Tokai University Hachioji Hospital, Tokyo 192-0032, Japan.
Oncol Rep. 2009 May;21(5):1203-8. doi: 10.3892/or_00000342.
In July 2008, a 40-year-old man presented to his local physician with diffuse abdominal pain and severe abdominal distension. Impending bowel rupture due to colonic obstruction was strongly suspected. Complete obstruction of the distal sigmoid colon by a tumor was diagnosed, and emergency surgery was performed. A sigmoid colon loop colostomy was created within the range of subsequent resection to relieve the obstruction. After his general condition had improved and the risks were assessed, curative resection including removal of the stoma was performed by hybrid 2-port hand-assisted laparoscopic surgery. The tumor showed invasion of the serosa without lymph node metastasis, and its pathological diagnosis was stage II. Postoperatively, mild wound infection occurred at the hand access site (stoma), but it resolved with conservative treatment, and the patient was discharged on postoperative day 13. This case is reported here because of the good results.
2008年7月，一名40岁男性因弥漫性腹痛和严重腹胀前往当地医生处就诊。强烈怀疑因结肠梗阻导致即将发生肠破裂。诊断为乙状结肠远端被肿瘤完全梗阻，并进行了急诊手术。在后续切除范围内做了乙状结肠袢式结肠造口术以缓解梗阻。在其一般状况改善并评估风险后，通过双孔手辅助腹腔镜手术进行了包括切除造口在内的根治性切除。肿瘤显示侵犯浆膜但无淋巴结转移，其病理诊断为II期。术后，手部入路部位（造口）发生轻度伤口感染，但经保守治疗后痊愈，患者于术后第13天出院。由于效果良好，特此报告此病例。
