Department of Surgery, Fujita Health University, Toyoake, Japan.
Department of Advanced Robotic and Endoscopic Surgery, Fujita Health University School of Medicine, Toyoake, Japan.
Asian J Endosc Surg. 2024 Oct;17(4):e13366. doi: 10.1111/ases.13366.
Subtotal colectomy is often performed on patients with synchronous colorectal cancer. However, compared with colorectal anastomosis, ileorectal anastomosis with subtotal colectomy is more likely to result in bowel dysfunction. The Deloyers procedure is useful in preserving bowel function in a patient with synchronous colorectal cancer. An 87-year-old man presented with bloody stool. Colonoscopy showed masses in the cecum, transverse colon, rectosigmoid, and rectum above the peritoneal reflection. Computed tomography scan revealed no evidence of regional lymph node swelling and distant metastasis. Therefore, robot-assisted low anterior resection, laparoscopic extended left hemicolectomy, laparoscopic cecal resection, and diverting ileostomy were performed. The patient was discharged from the hospital without complications. There was no recurrence, and the patient did not have complaints such as urgency, fecal incontinence, and excretory dysfunction. Hence, minimally invasive coloproctectomy using the Deloyers procedure can be safe and useful in preserving postoperative bowel function in elderly patients.
全结肠切除术常用于治疗同时性结直肠癌患者。然而，与结直肠吻合术相比，全结肠切除术后行回肠直肠吻合术更容易导致肠功能紊乱。在同时性结直肠癌患者中，Deloyers 手术有助于保留肠功能。一位 87 岁男性因血便就诊。结肠镜检查显示盲肠、横结肠、直肠乙状结肠和腹膜反射上方直肠有肿块。计算机断层扫描显示无区域淋巴结肿大和远处转移的证据。因此，行机器人辅助低位前切除术、腹腔镜扩大左半结肠切除术、腹腔镜盲肠切除术和预防性回肠造口术。患者无并发症出院。无复发，患者无急迫感、大便失禁和排泄功能障碍等抱怨。因此，使用 Deloyers 手术的微创结直肠切除术在保留老年患者术后肠功能方面是安全且有效的。
