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经肛门内镜显微手术（TEM）清创和修复治疗低位前切除术后吻合口漏

Management of anastomotic leak after low anterior resection with transanal endoscopic microsurgical (TEM) debridement and repair.

作者信息

Sneider Eb, Maykel Ja

机构信息

Department of Surgery, University of Massachusetts Medical School, Worcester, Masachusetts, USA.

出版信息

J Surg Case Rep. 2012 Sep 1;2012(9):1. doi: 10.1093/jscr/2012.9.1.

DOI:10.1093/jscr/2012.9.1
PMID:24960787
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3649630/
Abstract

Anastomotic leak after low anterior resection (LAR) in patients with rectal cancer who have received neoadjuvant chemoradiation can be challenging to treat and can lead to the creation of a permanent stoma. We report the case of a post-operative anastomotic leak after a Baker-type anastomosis during a low anterior resection was successfully managed with transanal endoscopic microsurgical (TEM) debridement and repair. TEM can be a successful endoluminal alternative treatment in the management of anastomotic leak after LAR and can prevent the morbidity associated with re-exploration and colostomy.

摘要

在接受新辅助放化疗的直肠癌患者中，低位前切除术（LAR）后发生吻合口漏可能难以治疗，并可能导致永久性造口的形成。我们报告了1例低位前切除术中Baker型吻合术后发生吻合口漏的病例，经肛门内镜显微手术（TEM）清创和修复成功处理。TEM可以作为LAR术后吻合口漏管理中一种成功的腔内替代治疗方法，并可预防再次手术和结肠造口相关的并发症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/103f/3649630/f295508b884c/jscr-2012-9-1fig5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/103f/3649630/a2271b7ce2e5/jscr-2012-9-1fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/103f/3649630/3c5737862123/jscr-2012-9-1fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/103f/3649630/3946a12e8819/jscr-2012-9-1fig3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/103f/3649630/1ca21aef5c79/jscr-2012-9-1fig4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/103f/3649630/f295508b884c/jscr-2012-9-1fig5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/103f/3649630/a2271b7ce2e5/jscr-2012-9-1fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/103f/3649630/3c5737862123/jscr-2012-9-1fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/103f/3649630/3946a12e8819/jscr-2012-9-1fig3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/103f/3649630/1ca21aef5c79/jscr-2012-9-1fig4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/103f/3649630/f295508b884c/jscr-2012-9-1fig5.jpg

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Anastomotic leak rate after low anterior resection for rectal cancer after chemoradiation therapy.直肠癌放化疗后行低位前切除术后的吻合口漏发生率
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Outcomes of low anterior resection anastomotic leak after preoperative chemoradiation therapy for rectal cancer.直肠癌术前放化疗后低位前切除术吻合口漏的结局
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Risk factors for anastomotic leakage after left-sided colorectal resection with rectal anastomosis.左半结肠切除直肠吻合术后吻合口漏的危险因素。
Dis Colon Rectum. 2003 May;46(5):653-60. doi: 10.1007/s10350-004-6627-9.