Department of Surgery, Mennonite Christian Hospital, Hualien 970, Taiwan.
World J Gastroenterol. 2013 Mar 7;19(9):1489-93. doi: 10.3748/wjg.v19.i9.1489.
A 36-year-old male was admitted with right lower abdominal pain and diarrhea for more than 3 mo. Colonoscopy and a barium enema study revealed a submucosal tumor over the cecum, but computed tomography showed an ileal lipoma. There was no definitive diagnosis preoperatively, but ileocolic intussusception was noted during surgery. Single port laparoscopic radical right hemicolectomy was performed because intra-operative reduction failed. The histological diagnosis of the resected tumor was lipoma. Single port laparoscopic surgery has recently been proven to be safe and feasible. There are advantages compared with conventional laparoscopic surgery, such as smaller incision wounds, fewer port site complications, and easier conversion. However, there are some drawbacks which need to be overcome, such as difficulties in triangulation and instrument clashing. If there are no contraindications to laparoscopy, single port laparoscopic surgery can be performed safely and should be considered for diagnosis and treatment of intussusception in adults. Here, we report the first case of ileocolic intussusception successfully treated by single port laparoscopic surgery.
一位 36 岁男性因右下腹痛和腹泻超过 3 个月入院。结肠镜和钡灌肠检查显示盲肠有黏膜下肿瘤,但 CT 显示回肠脂肪瘤。术前无明确诊断,但术中发现回结肠肠套叠。因术中复位失败,行单孔腹腔镜根治性右半结肠切除术。切除肿瘤的组织学诊断为脂肪瘤。单孔腹腔镜手术最近已被证明是安全可行的。与传统腹腔镜手术相比具有一些优势,如切口创伤更小、更少的端口部位并发症以及更容易转换。然而,仍存在一些需要克服的缺点,如三角定位和器械碰撞困难。如果没有腹腔镜手术的禁忌症,可以安全地进行单孔腹腔镜手术,应考虑将其用于成人肠套叠的诊断和治疗。在此,我们报告首例成功通过单孔腹腔镜手术治疗的回结肠肠套叠病例。