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结肠镜检查联合肠梗阻导管及支架成功治疗吻合口漏:1例病例报告及文献简要综述

Successful treatment of anastomotic leakage with an intestinal obstruction catheter and stent by colonoscopy: a case report and brief literature review.

作者信息

Huang Wang, Tan Zhenzong, Sun Hao

机构信息

Department of Gastrointestinal Surgery, Chongqing University Cancer Hospital, Chongqing, China.

出版信息

Front Oncol. 2024 Sep 17;14:1428452. doi: 10.3389/fonc.2024.1428452. eCollection 2024.

Abstract

BACKGROUND

Anastomotic leakage (AL) is one of the most common, severe, and difficult-to-treat complications after colorectal cancer surgery. However, to date, the best treatment options for AL remain elusive.

CASE DESCRIPTION

Here, we report the case of a 70-year-old man who had previously undergone Hartmann's surgery and developed a large AL after a colostomy reversal surgery in an external hospital. The condition mainly manifested as passage of the fecal material through the abdominal drainage tube accompanied by fever after intestinal surgery. We used a new method involving a transanal obstruction catheter combined with an anastomotic stent, along with fasting, administration of parenteral nutrition, and anti-infection treatment. By following this approach, AL was successfully cured without any complications.

CONCLUSION

To the best of our knowledge, this is the first case of the use of a transanal intestinal obstruction catheter combined with an anastomotic stent for treating colorectal AL; the findings may guide clinicians to better treat and manage AL.

摘要

背景

吻合口漏(AL)是结直肠癌手术后最常见、最严重且最难治疗的并发症之一。然而,迄今为止,AL的最佳治疗方案仍不明确。

病例描述

在此,我们报告一例70岁男性患者的病例,该患者先前接受过哈特曼手术,在外院进行结肠造口回纳手术后出现了较大的吻合口漏。该病症主要表现为肠道手术后粪便经腹腔引流管排出并伴有发热。我们采用了一种新方法,即经肛门置入梗阻导管并联合吻合支架,同时禁食、给予肠外营养及抗感染治疗。通过这种方法,吻合口漏成功治愈,未出现任何并发症。

结论

据我们所知,这是首例使用经肛门肠梗阻导管联合吻合支架治疗结直肠吻合口漏的病例;这些发现可能会指导临床医生更好地治疗和处理吻合口漏。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4b59/11442532/ed2f6a20b80b/fonc-14-1428452-g001.jpg

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