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腹腔镜下巨大直肠后肿瘤切除术

Laparoscopic Resection of a Huge Retrorectal Tumor.

作者信息

Kwak Han Deok, Ju Jae Kyun

机构信息

Department of Surgery, Chonnam National University Hospital, Gwangju, Korea.

出版信息

Ann Coloproctol. 2020 Feb;36(1):54-57. doi: 10.3393/ac.2018.07.31.1. Epub 2020 Feb 29.

Abstract

Retrorectal space tumors are rare, and so are frequently unrecognized, misdiagnosed, and mistreated. A 57-year-old man visited the outpatient clinic with the chief complaints of thin stool and lower pelvic heaviness. A smooth, round huge palpable mass on the right posterolateral rectal wall was detected and pelvic computed tomography showed a 7.8-cm cystic lesion in the right retrorectal space. Laparoscopic procedures were initiated with perirectal dissection for rectal mobilization. After fixation of the peritoneum and tying the rectum for intracorporeal traction, the rectum was mobilized to identify the cyst. The cyst was removed using an endo-bag, with completion of cyst dissection. The final pathologic diagnosis was a tailgut cyst, or retrorectal cystic hamartoma without evidence of malignancy. The patient was discharged without any complications. The patient had no dyschezia or problems with bowel function. Laparoscopic resection is a safe and feasible method for surgical treatment, even for bulky retrorectal tumors, with an early recovery period.

摘要

直肠后间隙肿瘤较为罕见,因此常常未被识别、误诊和误治。一名57岁男性因大便变细和下腹部坠胀为主诉前来门诊就诊。在直肠右后外侧壁可触及一个光滑、圆形的巨大肿块,盆腔计算机断层扫描显示直肠后间隙右侧有一个7.8厘米的囊性病变。启动腹腔镜手术,进行直肠周围解剖以游离直肠。在固定腹膜并结扎直肠以进行体内牵引后,游离直肠以识别囊肿。使用内袋取出囊肿,完成囊肿剥离。最终病理诊断为尾肠囊肿,即直肠后囊性错构瘤,无恶性证据。患者无并发症出院。患者无排便困难或肠道功能问题。腹腔镜切除术是一种安全可行的手术治疗方法,即使对于体积较大的直肠后肿瘤也是如此,且恢复早期。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6d59/7069681/42ea2b773c72/ac-2018-07-31-1f1.jpg

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