Wu Xian-Rui, Liang Wei-Wen, Zhang Xing-Wei, Kang Liang, Lan Ping
Department of Colorectal Surgery, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou City, Guangdong Province, PR China.
Department of Colorectal Surgery, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou City, Guangdong Province, PR China.
Int J Surg Case Rep. 2017;39:164-167. doi: 10.1016/j.ijscr.2017.08.010. Epub 2017 Aug 10.
The safety and feasibility of transanal total mesorectal excision (TaTME) were demonstrated in the management of rectal cancer. However, its role in the management of patients with diffuse cavernous hemangioma of the rectum (DCHR) has not been evaluated.
A female patient with DCHR was admitted to our hospital. Colonoscopy, magnetic resonance imaging (MRI), abdominal computed tomography (CT) and arteriography were performed. Lesions were detected in mesorectum and rectal wall extending from the dentate line to 5cm proximally. TaTME with a protecting loop ileostomy were performed. The research work has been reported in line with the SCARE criteria Agha et al., 2016 [1].
TaTME and a protecting loop ileostomy were safely performed, with an intact mesorectal specimen being harvested. The entire procedure took 348min. The estimated blood loss was 100ml. The patient recovered uneventfully. Her symptom of painless rectal bleeding was resolved satisfactorily following the surgery. The histopathological evaluation confirmed the diagnosis of DCHR.
TaTME appears to be a safe and feasible procedure for patients with DCHR in experienced hands.
经肛门全直肠系膜切除术（TaTME）在直肠癌治疗中的安全性和可行性已得到证实。然而，其在直肠弥漫性海绵状血管瘤（DCHR）患者治疗中的作用尚未得到评估。
一名患有DCHR的女性患者入住我院。进行了结肠镜检查、磁共振成像（MRI）、腹部计算机断层扫描（CT）和动脉造影。在直肠系膜和直肠壁中检测到病变，病变从齿状线向近端延伸至5cm。实施了带保护性回肠造口术的TaTME。本研究工作已按照SCARE标准（Agha等人，2016年[1]）进行报告。
安全实施了TaTME和保护性回肠造口术，获取了完整的直肠系膜标本。整个手术过程耗时348分钟。估计失血量为100ml。患者恢复顺利。术后，她无痛性直肠出血的症状得到了令人满意的缓解。组织病理学评估证实了DCHR的诊断。
在经验丰富的医生手中，TaTME似乎是治疗DCHR患者的一种安全可行的手术方法。
