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回肠袢式造口脱垂并坏疽远端肢体至端袢造口的微创矫正术

Minimally Invasive Correction of Prolapsed, Gangrenous Distal Limb of Loop Ileostomy to End-Loop Stoma.

作者信息

Shelton John, Rajendra Sittampalam

机构信息

University Surgical Unit, Teaching Hospital, Jaffna, Sri Lanka.

出版信息

Case Rep Surg. 2020 Nov 6;2020:8873388. doi: 10.1155/2020/8873388. eCollection 2020.

Abstract

INTRODUCTION

Prolapse can be a complication of loop stomas. A prolapsed stoma which cannot be reduced or complicated with strangulation needs surgical correction. This case report describes a minimal access correction of a prolapsed gangrenous distal limb of ileostomy. . A 67-year-old male patient was diagnosed with a lower rectal carcinoma, staged T3N1M0. Following neoadjuvant chemoradiation, he underwent a laparoscopic anterior resection with a defunctioning loop ileostomy. One month later, he presented with prolapse of the distal limb of the ileostomy. The limb was gangrenous and the gangrenous part was removed by using a linear GI stapler, and the loop ileostomy was converted to end-loop ileostomy. . It is a simple and technically feasible method for treating a prolapsed loop of the stoma. It is less invasive and has minimal postoperative complications. This technique reduces the duration of the hospital stay of the patient.

CONCLUSION

Stapled assisted correction of prolapsed stoma avoids unnecessary laparotomy and aids in expedite recovery after surgery. It is beneficial for a surgeon to be familiar with the minimal access correction for stoma prolapse.

摘要

引言

脱垂可能是袢式造口的一种并发症。无法回纳或并发绞窄的脱垂造口需要手术矫正。本病例报告描述了对回肠造口脱垂坏疽的远端肢体进行的微创矫正。一名67岁男性患者被诊断为低位直肠癌,分期为T3N1M0。在新辅助放化疗后,他接受了腹腔镜前切除术并进行了去功能化袢式回肠造口术。一个月后,他出现了回肠造口远端肢体脱垂。该肢体已坏疽,使用线性胃肠吻合器切除了坏疽部分,并将袢式回肠造口术转换为端袢式回肠造口术。这是一种治疗造口脱垂袢的简单且技术上可行的方法。它创伤较小,术后并发症最少。该技术缩短了患者的住院时间。

结论

吻合器辅助矫正脱垂造口避免了不必要的剖腹手术,并有助于术后加快恢复。外科医生熟悉造口脱垂的微创矫正方法是有益的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/592d/7665926/5107135923b1/CRIS2020-8873388.001.jpg

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