Miyake Toru, Sonoda Hiromichi, Shimizu Tomoharu, Ueki Tomoyuki, Mori Haruki, Takebayashi Katsushi, Kaida Sachiko, Yamaguchi Tsuyoshi, Iida Hiroya, Ban Hiromitsu, Tani Masaji
Division of Gastrointestinal, Breast and General Surgery, Dept. of Surgery, Shiga University of Medical Science.
Gan To Kagaku Ryoho. 2018 Apr;45(4):740-742.
It is hard to determine treatment strategy for radiation induced carcinoma, because radiation cause fibrosis to adjacent organ.The patient was in the 70's, who underwent 70 Gy radiation therapy for prostate cancer 5 years ago.He visited hospital because of fecal occult blood.Endoscopic examination revealed laterally spreading tumor(LST)in rectal front wall, and he referred to our hospital in purpose of endoscopic submucosal dissection(ESD).We performed ESD for LST, following transanal minimally invasive surgery to suture mucosal defect.He discharged out hospital 9 days after operation without any adverse event except anal pain.Suturing of mucosal defect after ESD might be potent to prevent postoperative complications in radiation induced rectal cancer.
很难确定放射性癌的治疗策略，因为放疗会导致邻近器官纤维化。该患者为70多岁男性，5年前因前列腺癌接受了70 Gy的放射治疗。他因大便潜血就诊。内镜检查发现直肠前壁有侧向扩散性肿瘤（LST），为行内镜黏膜下剥离术（ESD）而转诊至我院。我们对LST进行了ESD，随后行经肛门微创手术缝合黏膜缺损。术后9天患者出院，除肛门疼痛外无任何不良事件。ESD后缝合黏膜缺损可能有助于预防放射性直肠癌的术后并发症。
