Piozzi Guglielmo Niccolò, Khobragade Krunal, Shin Seon Hui, Choo Jeong Min, Kim Seon Hahn
Division of Colon and Rectal Surgery, Department of Surgery, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea.
Department of Surgical Oncology, Alexis Multispecialty Hospital, Nagpur, India.
Ann Coloproctol. 2024 May;40(Suppl 1):S38-S43. doi: 10.3393/ac.2022.00829.0118. Epub 2023 Feb 8.
Intersphincteric resection (ISR) with coloanal anastomosis is an oncologically safe anus-preserving technique for very low-lying rectal cancers. Most studies focused on oncological and functional outcomes of ISR with very few evaluating long-term postoperative anorectal complications. Full-thickness prolapse of the neorectum is a relatively rare complication. This report presents the case of a 70-year-old woman presenting with full-thickness prolapse of the side limb of the side-to-end coloanal anastomosis occurring 2 weeks after the stoma closure and 2 months after a robotic partial ISR performed with the Da Vinci single-port platform. The anastomosis was revised through resection of the side limb and conversion of the side-to-end anastomosis into an end-to-end handsewn anastomosis with interrupted stitches. This study describes the first case of full-thickness prolapse of the side limb of the side-to-end handsewn coloanal anastomosis following ISR. Moreover, a revision of all reported cases of post-ISR full-thickness and mucosal prolapse was performed.
经括约肌间切除术（ISR）联合结肠肛管吻合术是一种针对极低位直肠癌的肿瘤学安全保肛技术。大多数研究聚焦于ISR的肿瘤学和功能结局，很少有研究评估术后长期的肛肠并发症。新直肠全层脱垂是一种相对罕见的并发症。本报告介绍了一例70岁女性患者的病例，该患者在造口关闭后2周、使用达芬奇单孔平台进行机器人辅助部分ISR术后2个月，出现了端侧结肠肛管吻合术侧支的全层脱垂。通过切除侧支并将端侧吻合术转换为间断缝合的端端手工吻合术对吻合口进行了修复。本研究描述了首例ISR后端侧手工结肠肛管吻合术侧支全层脱垂的病例。此外，还对所有已报道的ISR术后全层和黏膜脱垂病例进行了回顾。
