Takayama Satoru, Takeyama Hiromitsu
Department of Gastroenterological Surgery, Nagoya City University Graduate School of Medical Sciences 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya 467-8601 Japan.
Cases J. 2009 Jun 29;2:6714. doi: 10.4076/1757-1626-2-6714.
We report a case of colonoscopy-assisted laparoscopic sigmoidectomy used for the management of sigmoid volvulus.
We report a 68-year-old female who underwent colonoscopy assisted laparoscopic sigmoidectomy. In this procedure, an anvil is inserted into the anus with colonoscopic assistance. An anastomosis is established without removing the colon from the abdominal cavity, and the maximum incision size is approximately 2 cm, similar to that in laparoscopic cholecystectomy. The risk of infection is lower compared with pure laparoscopic surgery, in which an incision is made for extracting the tissue specimen without opening the colon within the abdominal cavity to maintain anastomosis. The patient was discharged 1 week after surgery without complications.
We believe that this new technique is a feasible approach for the treatment of benign lesions, particularly sigmoid volvulus, which is generally large enough to allow insertion of the anvil.
我们报告一例结肠镜辅助腹腔镜乙状结肠切除术用于治疗乙状结肠扭转的病例。
我们报告一名68岁女性接受了结肠镜辅助腹腔镜乙状结肠切除术。在此手术中,在结肠镜辅助下将吻合器抵钉座经肛门插入。无需将结肠从腹腔取出即可完成吻合,最大切口尺寸约为2厘米,与腹腔镜胆囊切除术相似。与单纯腹腔镜手术相比,感染风险更低,单纯腹腔镜手术需做切口以取出组织标本,且不在腹腔内打开结肠以维持吻合。患者术后1周出院,无并发症。
我们认为这项新技术是治疗良性病变的一种可行方法,特别是乙状结肠扭转,其通常足够大以允许插入吻合器抵钉座。