自动腹膜透析患者腹腔镜下横结肠癌切除术：一例报告
Laparoscopic colectomy for transverse colon cancer in an automated peritoneal dialysis patient: A case report.
作者信息
Torigoe Takayuki, Akiyama Yasuki, Uehara Tomohito, Nakayama Yoshifumi, Yamaguchi Koji
机构信息
Department of Surgery 1, School of Medicine, University of Occupational and Environmental Health, Kitakyushu 807-8555, Japan.
出版信息
Int J Surg Case Rep. 2013;4(7):640-2. doi: 10.1016/j.ijscr.2013.04.031. Epub 2013 Apr 30.
INTRODUCTION
To date, intra-abdominal surgery in patients undergoing peritoneal dialysis (PD) has been considered to be associated with increased risk even when it is performed laparoscopically. To our knowledge, this is the first case of laparoscopic colectomy for transverse colon cancer in a patient undergoing automated PD (APD).
PRESENTATION OF CASE
A 67-year-old man undergoing APD for end-stage chronic renal failure secondary to diabetic nephropathy was diagnosed with transverse colon cancer. Laparoscopic tumor resection without removal of the PD catheter was performed uneventfully. After surgery, PD was interrupted for 4 weeks and then safely resumed after confirming no severe complications of anastomotic leakage or intra-abdominal abscess.
DISCUSSION
In patients undergoing PD, the safety of laparoscopic surgery without removal of the catheter and the optimal timing of resuming postoperative PD with or without temporary hemodialysis remain controversial.
CONCLUSION
We believe that laparoscopic colectomy can be safely performed in patients undergoing PD. Further case reports and investigations on this procedure with special reference to safety are warranted in future.
引言
迄今为止，腹膜透析（PD）患者的腹腔内手术即便采用腹腔镜进行，也被认为风险会增加。据我们所知，这是首例为接受自动化腹膜透析（APD）的患者实施腹腔镜横结肠癌切除术的病例。
病例介绍
一名67岁男性因糖尿病肾病继发终末期慢性肾衰竭而接受APD治疗，被诊断为横结肠癌。在未拔除PD导管的情况下顺利进行了腹腔镜肿瘤切除术。术后，腹膜透析中断了4周，在确认无吻合口漏或腹腔内脓肿等严重并发症后安全恢复。
讨论
对于接受腹膜透析的患者，不拔除导管进行腹腔镜手术的安全性以及术后恢复腹膜透析（无论有无临时血液透析）的最佳时机仍存在争议。
结论
我们认为，接受腹膜透析的患者可以安全地进行腹腔镜结肠切除术。未来有必要进一步进行关于该手术安全性的病例报告和研究。
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