Vecchio R, Amore F, Marchese S, Zanghì G, Alongi G, Ferla F, Intagliata E
Department of Surgery, University of Catania, Italy.
G Chir. 2012 Aug-Sep;33(8-9):274-6.
The Authors discuss on a laparoscopic-assisted approach for excision of a sessile villous adenomatous polyp of the cecum, unresectable by endoscopy. Because of the large implant of the polyp, endoscopic polypectomy was considered at high risk and a surgical laparoscopic procedure was scheduled for removal of the lesion. After right colon mobilization, an intraoperative endoscopy confirmed the location of th polyp in the posterior wall of the cecum, closed to the ileo-cecal valve. A small 10 cm laparotomy, through which the cecum was pulled out the abdominal cavity, was performed. Then, a minimal colotomy along the intestinal taenia was carried out to allow a safe and complete excision of the polyp. This laparoscopic approach differs from the other laparoscopic-assisted methods reported in the Literature since it provides at the same time the postoperative advantages associated with minimal access surgery and a safe oncological removal of the polyp with low risks of complications.
作者讨论了一种腹腔镜辅助方法，用于切除无法通过内镜切除的盲肠广基绒毛状腺瘤性息肉。由于息肉植入范围较大，内镜下息肉切除术被认为风险很高，因此安排了腹腔镜手术来切除病变。在游离右半结肠后，术中内镜检查确认息肉位于盲肠后壁，靠近回盲瓣。做了一个10厘米的小剖腹切口，通过该切口将盲肠拉出腹腔。然后，沿着肠带进行最小限度的结肠切开术，以安全、完整地切除息肉。这种腹腔镜方法与文献中报道的其他腹腔镜辅助方法不同，因为它同时具有微创手术带来的术后优势，以及安全的肿瘤学切除息肉且并发症风险低的特点。
