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腹壁成形术联合手术治疗极度肥胖子宫内膜癌患者的疗效:病例报告及文献综述

Efficacy of panniculectomy-combined surgery in superobese patients with endometrial cancer: A case report and literature review.

作者信息

Okawa Masayo, Komatsu Hiroaki, Osaku Daiken, Sawada Mayumi, Kudoh Akiko, Shimogai Ruri, Chikumi Jun, Sato Shinya, Oishi Tetsuro, Harada Tasuku

机构信息

Department of Obstetrics and Gynecology, Tottori University School of Medicine, 36-1 Nishicho, Yonago, Tottori, 683-5804, Japan.

Department of Obstetrics and Gynecology, Tottori University School of Medicine, 36-1 Nishicho, Yonago, Tottori, 683-5804, Japan.

出版信息

Int J Surg Case Rep. 2020;72:99-103. doi: 10.1016/j.ijscr.2020.05.066. Epub 2020 Jun 6.

Abstract

INTRODUCTION

Panniculectomy is regarded as an effective approach in highly obese patients with endometrial cancer to improve surgical access or space of the surgical field.

PRESENTATION OF CASE

A 66-year-old nulliparous woman was brought in from another hospital to our institute for newly diagnosed endometrial carcinoma. The patient was 158 cm in height and weighed 135.8 kg during the first visit to our hospital. Her body mass Index (BMI) was 54.4 kg/m. Unfortunately, the patient developed an umbilical hernia and strangulation before the surgery. Emergency partial ileal resection and simple closure of the umbilical hernia were performed. We were finally able to perform simple hysterectomy, and bilateral salpingo-oophorectomy with panniculectomy. Her weight at the time of surgery was 115.5 kg which had been reduced by 20 kg from the time she was first brought in, and the BMI decreased from 54.4 to 45.3 kg/m. The patient underwent follow-up without adjuvant therapy since she was in the low-risk group, and showed no signs of recurrence 12 months after surgery.

DISCUSSION

There are various risks associated with surgery in highly obese patients. Diabetes mellitus, hypertension and smoking are reported to be risk factors of wound complication in panniculectomy, and it was reported that diabetes mellitus was an independent risk factor.

CONCLUSION

The combination of panniculectomy was considered as an effective approach to perform safe surgery for obese patients.

摘要

引言

对于肥胖的子宫内膜癌患者,腹壁成形术被视为一种改善手术入路或手术视野空间的有效方法。

病例介绍

一名66岁未生育女性从另一家医院转至我院,被诊断为子宫内膜癌。患者身高158厘米,首次来我院就诊时体重135.8千克。其体重指数(BMI)为54.4千克/平方米。不幸的是,患者在手术前出现脐疝并发生绞窄。遂行急诊部分回肠切除术及脐疝单纯修补术。最终我们成功实施了单纯子宫切除术、双侧输卵管卵巢切除术及腹壁成形术。手术时她的体重为115.5千克,较首次入院时减轻了20千克,BMI从54.4降至45.3千克/平方米。该患者因处于低风险组未接受辅助治疗而进行随访,术后12个月未出现复发迹象。

讨论

肥胖患者手术存在多种风险。据报道,糖尿病、高血压和吸烟是腹壁成形术伤口并发症的危险因素,且糖尿病是独立危险因素。

结论

腹壁成形术联合应用被认为是肥胖患者安全手术的有效方法。

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