腹腔镜袖状胃切除术作为肥胖患者结直肠癌手术的桥梁：一例报告

Laparoscopic sleeve gastrectomy as a bridge to colorectal cancer surgery for obese patients: a case report.

作者信息

Minagawa Yume, Amiki Manabu, Yuki Keisuke, Watanabe Kazuharu, Mochizuki Ichitaro, Ishiyama Yasuhiro, Hara Yoshiaki, Narita Kazuhiro, Hirano Yasumitsu

机构信息

Department of Surgery, Kawasaki Saiwai Hospital, 31-27 Omiya-Cho, Saiwai-Ku, Kawasaki-Shi, Kanagawa, 212-0014, Japan.

Saitama Medical University International Medical Center, Hidaka City, Saitama, Japan.

出版信息

Surg Case Rep. 2024 Sep 9;10(1):211. doi: 10.1186/s40792-024-02012-7.

DOI:10.1186/s40792-024-02012-7

PMID:39249641

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11383887/

Abstract

BACKGROUND

Severe obesity greatly influences the difficulty of colorectal cancer surgery and has been reported to prolong operative time, increase the rate of laparotomy, and elevate increase postoperative complications. We investigated the efficacy of laparoscopic sleeve gastrectomy (LSG) for preoperative weight loss to ensure safe colorectal cancer surgery.

CASE PRESENTATION

A 51 year-old female with a body mass index of 43.5 kg/m was referred to our hospital due to a positive fecal occult blood test. She was diagnosed as having a laterally spreading tumor of the cecum by colonoscopy. Endoscopic submucosal dissection was attempted but proved difficult due to the size of the lesion and its proximity to the appendiceal orifice. We planned bariatric surgery prior to colorectal surgery, and she underwent LSG without any complications. Seven months after the LSG, she had lost 30.7 kg, and her final preoperative body mass index was 27.8 kg/m. Single-incision laparoscopic ileocecal resection was then performed safely. The pathological diagnosis was adenocarcinoma in adenoma of the cecum, TisN0M0.

CONCLUSION

LSG was effective in reducing visceral fat and making it possible to perform safe surgery for colorectal cancer in a severely obese patient.

摘要

背景

严重肥胖极大地影响结直肠癌手术的难度，据报道会延长手术时间、增加剖腹手术率并提高术后并发症发生率。我们研究了腹腔镜袖状胃切除术（LSG）对术前减重以确保安全的结直肠癌手术的疗效。

病例报告

一名51岁女性，体重指数为43.5kg/m²，因粪便潜血试验阳性转诊至我院。经结肠镜检查诊断为盲肠侧向发育型肿瘤。尝试进行内镜下黏膜下剥离术，但由于病变大小及其与阑尾开口的距离，手术困难。我们计划在结直肠手术前进行减重手术，她接受了LSG且无任何并发症。LSG术后7个月，她体重减轻了30.7kg，术前最终体重指数为27.8kg/m²。随后安全地进行了单孔腹腔镜回盲部切除术。病理诊断为盲肠腺瘤性腺癌，TisN0M0。