Department of Gastrointestinal Surgery, Fujita Health University, Toyoake, Japan.
Department of Gastrointestinal Surgery, Fujita Health University Okazaki Medical Center, Toyoake, Japan.
Asian J Endosc Surg. 2022 Apr;15(2):401-404. doi: 10.1111/ases.13022. Epub 2021 Dec 21.
Obesity has been considered a risk factor for postoperative complications following colorectal cancer surgery. However, the usefulness of a combination of intracorporeal anastomosis and preoperative weight reduction for severely obese patients with colon cancer remains unclear. A 66-year-old man with a body mass index (BMI) of 43 kg/m presented with abdominal pain and iron deficiency anemia. Colonoscopy and computed tomography revealed advanced ascending colon cancer with regional lymph node metastasis and excessive abdominal fat. Preoperative diet-induced weight reduction was performed for severe obesity, which decreased his BMI to 39.7 kg/m after 1 month. Thereafter, curative resection was performed using intracorporeal anastomosis for reconstruction to achieve minimal colon and mesentery mobilization and a shorter incision. The patient was discharged from the hospital without complications. Laparoscopic right hemicolectomy combining intracorporeal anastomosis and preoperative weight reduction was extremely useful in the current patient with severe obesity and ascending colon cancer.
肥胖被认为是结直肠癌手术后并发症的一个危险因素。然而,对于患有结肠癌的肥胖患者,采用腔内吻合术和术前减重相结合的方法是否有用仍不清楚。一名 66 岁的男性,BMI 为 43kg/m²,出现腹痛和缺铁性贫血。结肠镜检查和计算机断层扫描显示升结肠癌伴局部淋巴结转移和大量腹部脂肪。为严重肥胖患者进行术前饮食诱导减重,1 个月后 BMI 降至 39.7kg/m²。此后,采用腔内吻合术进行根治性切除重建,以实现最小化的结肠和肠系膜移动和更短的切口。患者无并发症出院。腹腔镜右半结肠切除术联合腔内吻合术和术前减重对当前患有严重肥胖和升结肠癌的患者非常有用。