Morimoto Mitsuaki, Koinuma Koji, Lefor Alan K, Horie Hisanaga, Ito Homare, Sata Naohiro, Hayashi Yoshikazu, Sunada Keijiro, Yamamoto Hironori
Mitsuaki Morimoto, Koji Koinuma, Alan K Lefor, Hisanaga Horie, Homare Ito, Naohiro Sata, Department of Surgery, Jichi Medical University, Tochigi 329-0498, Japan.
World J Gastrointest Endosc. 2016 Apr 25;8(8):374-7. doi: 10.4253/wjge.v8.i8.374.
A 48-year-old man underwent laparoscopic sigmoid colon resection for cancer and surveillance colonoscopy was performed annually thereafter. Five years after the resection, a submucosal mass was found at the anastomotic staple line, 15 cm from the anal verge. Computed tomography scan and endoscopic ultrasound were not consistent with tumor recurrence. Endoscopic mucosa biopsy was performed to obtain a definitive diagnosis. Mucosal incision over the lesion with the cutting needle knife technique revealed a creamy white material, which was completely removed. Histologic examination showed fibrotic tissue without caseous necrosis or tumor cells. No bacteria, including mycobacterium, were found on culture. The patient remains free of recurrence at five years since the resection. Endoscopic biopsy with a cutting mucosal incision is an important technique for evaluation of submucosal lesions after rectal resection.
一名48岁男性因癌症接受了腹腔镜乙状结肠切除术，此后每年进行结肠镜监测。切除术后五年，在距肛缘15 cm的吻合钉合线处发现一个黏膜下肿物。计算机断层扫描和内镜超声检查结果与肿瘤复发不符。进行了内镜黏膜活检以明确诊断。采用切割针刀技术在病变处进行黏膜切开，发现一种乳白色物质，并将其完全切除。组织学检查显示为纤维化组织，无干酪样坏死或肿瘤细胞。培养未发现包括分枝杆菌在内的细菌。自切除术后五年，该患者仍无复发。采用切割黏膜切口进行内镜活检是评估直肠切除术后黏膜下病变的一项重要技术。
