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成功实施腹腔镜辅助下对一名患有多发性大肾囊肿及缺血性结肠炎所致结肠狭窄患者的降结肠切除术。

Successful Laparoscopy-Assisted Resection of the Descending Colon in a Patient with Multiple Large Renal Cysts and Stricture of the Colon due to Ischemic Colitis.

作者信息

Maeda Hiromichi, Okamoto Ken, Namikawa Tsutomu, Shiga Mai, Fujisawa Kazune, Tadokoro Michiko, Hanazaki Kazuhiro, Kobayashi Michiya

机构信息

Cancer Treatment Center, Kochi Medical School Hospital, Nankoku, Japan.

Department of Surgery, Kochi Medical School, Kochi University, Nankoku, Japan.

出版信息

Case Rep Gastroenterol. 2018 Aug 31;12(2):540-545. doi: 10.1159/000486953. eCollection 2018 May-Aug.

Abstract

Large pathological structures in the abdominal cavity curb the application of laparoscopic surgery. This case report describes a successful laparoscopy-assisted colectomy for benign colon disease in a patient with multiple large renal cysts. An 82-year-old man was referred to our department for treatment of stenosis of descending colon secondary to ischemic colitis. An abdominal computed tomography revealed multiple large renal cysts occupying a large proportion of the peritoneal cavity. To minimize the postoperative recovery period, laparoscopic surgery was planned despite the renal cysts. After inserting access ports, the walls of the several renal cysts were fenestrated with an electronic scalpel and the serous fluid was aspirated to enable continuation of the laparoscopic colectomy. The left colon was mobilized and extracted through an incision at the umbilicus, and the affected part of the colon was resected safely. The patient's postoperative course was uneventful, and the present case suggests that laparoscopy-assisted colectomy can be performed safely even in patients with multiple large renal cysts.

摘要

腹腔内的大型病理结构限制了腹腔镜手术的应用。本病例报告描述了一例成功的腹腔镜辅助结肠切除术,该手术用于一名患有多个大型肾囊肿的良性结肠疾病患者。一名82岁男性因缺血性结肠炎继发降结肠狭窄被转诊至我科。腹部计算机断层扫描显示多个大型肾囊肿占据了腹腔的很大一部分。为了尽量缩短术后恢复期,尽管存在肾囊肿,仍计划进行腹腔镜手术。插入接入端口后,用电子手术刀在几个肾囊肿壁上开窗,并抽出浆液,以便继续进行腹腔镜结肠切除术。游离左半结肠并通过脐部切口取出,安全切除结肠病变部位。患者术后恢复顺利,本病例表明,即使是患有多个大型肾囊肿的患者,也可以安全地进行腹腔镜辅助结肠切除术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/490b/6167646/14c2ae8e2005/crg-0012-0540-g01.jpg

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