Rusli Siti Mayuha, Choo Jeong Min, Piozzi Guglielmo Niccolò, Kim Seon Hahn
Division of Colon and Rectal Surgery, Department of Surgery, Korea University Anam Hospital, Korea University College of Medicine, Seoul, South Korea.
J Surg Case Rep. 2021 Nov 29;2021(11):rjab524. doi: 10.1093/jscr/rjab524. eCollection 2021 Nov.
Extensive resection that may be required in locally advanced and recurrent colorectal cancer result in formation of empty pelvic cavity that has the potential to cause small bowel descent into the pelvis. In patients with prior history of radiotherapy and multiple abdominal surgery, the risk of adhesion and subsequent small bowel obstruction can lead to increasing need for surgery and its resulting morbidity and mortality. We present five cases of locally advanced and recurrent colorectal cancer requiring laparoscopic and robotic-assisted pelvic closure with Gore-Tex Dual Mesh as prevention of small bowel descent into the pelvis. One out of the five cases had a history of small bowel obstruction after the surgery and wound-related infection occurred in one patient. There was no mesh-related complication or mortality. Pelvic closure using Gore-Tex Dual Mesh is feasible to prevent small bowel descent after surgery for locally advanced and recurrent colorectal cancer.
局部晚期和复发性结直肠癌可能需要进行广泛切除,这会导致盆腔空虚,有可能引起小肠坠入盆腔。对于有放疗史和多次腹部手术史的患者,粘连风险及随后的小肠梗阻会导致手术需求增加及其带来的发病率和死亡率。我们展示了5例局部晚期和复发性结直肠癌患者,他们需要使用戈尔特斯双网片进行腹腔镜和机器人辅助盆腔封闭术,以预防小肠坠入盆腔。5例中有1例术后有小肠梗阻史,1例患者发生了伤口相关感染。没有与网片相关的并发症或死亡病例。使用戈尔特斯双网片进行盆腔封闭术对于预防局部晚期和复发性结直肠癌手术后的小肠坠入是可行的。