Takezawa Kentaro, Kakimoto Kenichi, Yoshida Takahiro, Arai Yasuyuki, Ono Yutaka, Meguro Norio, Usami Michiyuki, Ohue Masayuki
The Department of Urology, Osaka Medical Center for Cancer and Cardiovascular Diseases.
Hinyokika Kiyo. 2009 Dec;55(12):773-5.
The patient, a 56-year-old man, had surgery for anal fistula at the age of 28. In August 2007, he underwent a radical retropubic prostatectomy (RRP) for prostate cancer. Rectal injury was not recognized during the operation. However, on the 8th postoperative day, fecaluria appeared, and rectourethral fistula was diagnosed. We attempted conservative therapy including diverting colostomy and continued drainage using a urethral catheter. Subsequently, the fistula closed spontaneously 3 months after RRP. Eight months after RRP, we performed a transanal repair of rectal mucosa based on the rectal wall advancement flap procedure. The postoperative course was uneventful, and the colostomy was closed in July 2008. By April 2009, he had normal voiding and full anal continence without fistula recurrence.
该患者为一名56岁男性,28岁时接受了肛瘘手术。2007年8月,他因前列腺癌接受了根治性耻骨后前列腺切除术(RRP)。手术过程中未发现直肠损伤。然而,术后第8天出现了粪尿,诊断为直肠尿道瘘。我们尝试了包括转流性结肠造口术在内的保守治疗,并使用尿道导管持续引流。随后,瘘在RRP术后3个月自行闭合。RRP术后8个月,我们基于直肠壁推进皮瓣手术进行了经肛门直肠黏膜修复。术后过程顺利,结肠造口于2008年7月关闭。到2009年4月,他排尿正常,肛门完全自控,瘘未复发。