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采用德洛姆技术矫正末端结肠造口脱垂。病例报告。

Correction of an end colostomy prolapse with the Delorme technique. A case report.

作者信息

Marrosu Antonio, Paliogiannis Panagiotis, Sassu Maria Angela, Attene Federico, Trignano Mario

机构信息

Department of Surgery, Microsurgery and Medical, Surgical Specialties, University of Sassari, Sassari, Italy.

出版信息

Ann Ital Chir. 2012 Nov-Dec;83(6):567-9.

Abstract

INTRODUCTION

We report a case of correction of an end colostomy prolapse with Delorme technique in an advanced stage oncologic patient to emphasize the clinical implications and advantages of this procedure.

CASE REPORT

A 51-year-old male patient with a stage IV rectal adenocarcinoma underwent laparoscopy for a palliative end colostomy at our institution. Approximately 6 months later, a prolapse of the colostomy occurred during chemotherapeutic treatment. The patient complained of progressive onset of pain and bleeding during defecation as well as difficulty managing the pouch system. Given the stage of the disease and the on-going chemotherapy, a minimally invasive approach was desirable for prolapse correction and we opted for the Delorme procedure under local anesthesia. The postoperative course was excellent with no complications, the symptoms regressed rapidly, and defecation was normal immediately after surgery. The patient was discharged on the second post-operative day. After discharge the stoma was periodically controlled, confirming the success of the procedure. The last clinical evaluation was performed 3 months after surgery and stability was observed.

CONCLUSIONS

The Delorme technique is a minimally invasive procedure used to correct an end colostomy prolapse. This technique guarantees excellent results in selected patients and permits the avoidance of more invasive procedures.

摘要

引言

我们报告一例晚期肿瘤患者采用德洛姆技术矫正末端结肠造口脱垂的病例,以强调该手术的临床意义和优势。

病例报告

一名51岁男性患者,患有IV期直肠腺癌,在我院接受了腹腔镜姑息性末端结肠造口术。大约6个月后,在化疗期间发生了结肠造口脱垂。患者主诉排便时疼痛和出血逐渐加重,以及难以管理造口袋系统。鉴于疾病阶段和正在进行的化疗,对于脱垂矫正,微创方法是可取的,我们选择在局部麻醉下进行德洛姆手术。术后过程顺利,无并发症,症状迅速消退,术后排便立即恢复正常。患者术后第二天出院。出院后定期检查造口,证实手术成功。术后3个月进行了最后一次临床评估,观察到病情稳定。

结论

德洛姆技术是一种用于矫正末端结肠造口脱垂的微创手术。该技术在特定患者中可保证出色的效果,并避免了更具侵入性的手术。

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