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1例直肠癌低位前切除术后因结肠缺血导致的术后狭窄，随后进行了延迟结肠肛管吻合术。

A case of post-operative stenosis caused by colonic ischemia after low anterior resection for rectal cancer, followed by delayed colo-anal anastomosis.

作者信息

Uchiyama Shuichiro, Ikeda Naotaka, Oyama Tomohiro, Eguchi Mayumi, Ito Ayaka, Sato Rikiya, Toyosaki Ryoichi, Kitazono Masaki, Suenaga Toyokuni

机构信息

Department of Surgery, Nanpuh Hospital, Kagoshima-city, Kagoshima, Japan.

出版信息

J Surg Case Rep. 2022 May 18;2022(5):rjac236. doi: 10.1093/jscr/rjac236. eCollection 2022 May.

DOI:10.1093/jscr/rjac236
PMID:35599998
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9116574/
Abstract

Cases of delayed colo-anal anastomosis (DCAA) are currently reported instead of the colo-anal anastomosis with a protective loop ileostomy for rectal cancer. Post-operative colonic ischemia is considered as one of the serious complications of colorectal resection. Although indication of DCAA should be carefully selected, we experienced a case of post-operative stenosis caused by colonic ischemia after low anterior resection for rectal cancer, followed by this procedure.

摘要

目前报道的是延迟结肠肛管吻合术（DCAA）的病例，而非直肠癌结肠肛管吻合术加保护性回肠造口术。术后结肠缺血被认为是结直肠切除术后的严重并发症之一。尽管DCAA的适应证应谨慎选择，但我们遇到了一例直肠癌低位前切除术后因结肠缺血导致术后狭窄的病例，随后采用了该手术方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7f6b/9116574/7f66196cb2f4/rjac236f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7f6b/9116574/48a859f07fb8/rjac236f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7f6b/9116574/7f66196cb2f4/rjac236f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7f6b/9116574/48a859f07fb8/rjac236f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7f6b/9116574/7f66196cb2f4/rjac236f2.jpg

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本文引用的文献

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JAMA Surg. 2020 Aug 1;155(8):e201625. doi: 10.1001/jamasurg.2020.1625. Epub 2020 Aug 19.
2
Diverting Ostomy: For Whom, When, What, Where, and Why.转流性造口术：适用于何人、何时、何种情况、何处以及为何施行
Clin Colon Rectal Surg. 2019 May;32(3):171-175. doi: 10.1055/s-0038-1677004. Epub 2019 Apr 2.
3
Delayed Colo-anal Anastomosis for Rectal Cancer: Pelvic Morbidity, Functional Results and Oncological Outcomes: A Systematic Review.
直肠癌的延迟结肠肛管吻合术：盆腔发病率、功能结果和肿瘤学结局：一项系统评价
World J Surg. 2019 May;43(5):1360-1369. doi: 10.1007/s00268-019-04918-y.
4
Preoperative, intraoperative and postoperative risk factors for anastomotic leakage after laparoscopic low anterior resection with double stapling technique anastomosis.腹腔镜低位前切除术采用双吻合器技术吻合术后吻合口漏的术前、术中和术后危险因素。
World J Gastroenterol. 2016 Jul 7;22(25):5718-27. doi: 10.3748/wjg.v22.i25.5718.
5
Diverting ileostomy in colorectal surgery: when is it necessary?结直肠手术中的转流性回肠造口术：何时有必要？
Langenbecks Arch Surg. 2015 Feb;400(2):145-52. doi: 10.1007/s00423-015-1275-1. Epub 2015 Jan 30.
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Anastomotic salvage after rectal cancer resection using the Turnbull-Cutait delayed anastomosis.直肠癌切除术后采用特恩布尔-卡泰特延迟吻合术进行吻合口挽救。
Can J Surg. 2014 Dec;57(6):405-11. doi: 10.1503/cjs.001014.
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The role of faecal diversion in low rectal cancer: a review of 1791 patients having rectal resection with anastomosis for cancer, with and without a proximal stoma.粪便转流在低位直肠癌中的作用：对 1791 例接受直肠癌切除术和吻合术的癌症患者（有和无近端造口术）的回顾性研究。
Colorectal Dis. 2013 Jun;15(6):e309-16. doi: 10.1111/codi.12248.
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