Conzo Giovanni, Mauriello Claudio, Gambardella Claudio, Cavallo Fabio, Tartaglia Ernesto, Napolitano Salvatore, Santini Luigi
Giovanni Conzo, Claudio Mauriello, Claudio Gambardella, Fabio Cavallo, Ernesto Tartaglia, Salvatore Napolitano, Luigi Santini, Department of Anaesthesiologic, Surgical and Emergency Science, VII Division of General Surgery, Second University of Naples, 80131 Naples, Italy.
World J Gastroenterol. 2014 Nov 21;20(43):16343-8. doi: 10.3748/wjg.v20.i43.16343.
Repeated anastomotic recurrence (AR) of colonic cancer is uncommon. We report a case of a double-isolated AR after sigmoidectomy. In 2003, a 60-year-old woman underwent stapled sigmoid resection for a moderately differentiated adenocarcinoma. Further rectal bleeding occurred after six months, and colonoscopy detected an AR. Thus, an additional stapled colorectal anastomosis was performed. Ten months later, a colonoscopy detected a circumferential AR that prompted the completion of a second colorectal resection, with a double-stapled colorectal anastomosis. Twenty-four hours after surgery, a massive pulmonary embolism occurred, and the patient died within a few hours. At present, only six cases of repeated isolated AR have been described. Repeated segmental colorectal resections are generally associated with a favourable prognosis, with a median survival rate of 45 mo (range, 13-132 mo). Repeated isolated ARs are rare, and segmental colorectal resections are generally associated with long-term disease-free survival.
结肠癌的反复吻合口复发（AR）并不常见。我们报告一例乙状结肠切除术后双孤立性AR病例。2003年，一名60岁女性因中度分化腺癌接受了吻合器乙状结肠切除术。六个月后出现进一步的直肠出血，结肠镜检查发现AR。因此，又进行了一次吻合器结直肠吻合术。十个月后，结肠镜检查发现环形AR，促使完成第二次结直肠切除术，并进行了双吻合器结直肠吻合术。术后24小时发生大面积肺栓塞，患者在数小时内死亡。目前，仅描述了6例反复孤立性AR病例。反复节段性结直肠切除术通常预后良好，中位生存率为45个月（范围13 - 132个月）。反复孤立性AR很少见，节段性结直肠切除术通常与长期无病生存相关。
