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[1例乙状结肠癌伴黏膜下浸润切除术后10年吻合口复发的病例]

[A Case of Anastomotic Recurrence 10 Years after Excision of Sigmoid Colon Cancer with Submucosal Invasion].

作者信息

Nakanishi Ryo, Tsutsui Atsuko, Tanaka Hiroto, Igarashi Kazuharu, Ozaki Takahiro, Ishii Satoru, Kinugawa Noriko, Wakabayashi Go

机构信息

Dept. of Surgery, Ageo Central General Hospital.

出版信息

Gan To Kagaku Ryoho. 2021 Jun;48(6):833-836.

Abstract

A 72-year-old woman underwent sigmoid colon resection plus D2 lymph node dissection in 2008, with additional resection after endoscopic mucosal resection(EMR). Histopathological examination revealed only atypical ducts in the EMR scar, with no invasion below the submucosa. No lymphatic, venous, or nerve invasions were confirmed, and oral and anal stumps and lymph node metastases were negative. She was followed up for 5 years after the surgery, and no recurrence was detected. In 2018, she visited our hospital with the chief complaint of diarrhea and constipation. Colonoscopy revealed a circumferential lesion around the anastomosis. She underwent laparoscopic low anterior resection for suspected anastomotic recurrence, which was confirmed by histopathological diagnosis. The anastomotic recurrence 10 years after surgery for SM cancer of the colon with negative lymph node metastasis and vascular factor was extremely rare. We recognized the importance of surveillance 5 years after surgery.

摘要

一名72岁女性于2008年接受了乙状结肠切除术加D2淋巴结清扫术,内镜黏膜切除术(EMR)后又进行了额外切除。组织病理学检查显示EMR瘢痕中仅有非典型导管,黏膜下层以下无浸润。未证实有淋巴、静脉或神经侵犯,切缘及淋巴结转移均为阴性。术后随访5年,未发现复发。2018年,她因腹泻和便秘为主诉前来我院就诊。结肠镜检查发现吻合口周围有环形病变。她因怀疑吻合口复发接受了腹腔镜低位前切除术,组织病理学诊断证实了这一点。结肠癌黏膜下层癌术后10年出现吻合口复发,且淋巴结转移和血管因素均为阴性,极为罕见。我们认识到术后5年监测的重要性。

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