腹腔镜腹会阴联合切除术及肌皮瓣重建术治疗复杂性肛瘘继发肛瘘癌：两例报告
Laparoscopic abdominoperineal resection and myocutaneous flap reconstruction for anal fistula cancer arising from complicated anal fistula: two case reports.
作者信息
Kuroiwa Hidemichi, Nakamura Yuki, Matsuda Kenji, Iwamoto Hiromitsu, Mitani Yasuyuki, Shimomura Kazuki, Takemoto Norio, Sakanaka Toshihiro, Tamiya Masato, Hyo Takahiko, Kawai Manabu
机构信息
Second Department of Surgery, School of Medicine, Wakayama Medical University, 811-1, Kimiidera, Wakayama, 641-8510, Japan.
出版信息
Surg Case Rep. 2024 Oct 8;10(1):233. doi: 10.1186/s40792-024-02037-y.
BACKGROUND
Anal fistula cancer is rare and definitive treatment has not yet been established. Laparoscopic abdominoperineal resection is generally the first choice of treatment if the cancer is determined to be resectable. However, complicated anal fistula cancer often requires extensive resection. Using a myocutaneous flap for reconstruction after resection in such cases, radical resection can be performed regardless of the size of the anal fistula cancer.
CASE PRESENTATION
We report two cases in which we performed laparoscopic abdominoperineal resection with extensive buttock resection and myocutaneous flap reconstruction for widespread anal fistula cancer. One of the cases was reconstruction with a posterior thigh flap, the other was with a bilateral expanded gluteus maximus flap. Both cases were anal fistula cancers that developed from complicated anal fistulas.
CONCLUSIONS
If the size of anal fistula cancer is large and extended buttock resection is necessary, radical resection of anal fistula cancer is possible using myocutaneous flap for reconstruction after extended abdominoperineal resection.
背景
肛瘘癌罕见，且尚未确立明确的治疗方法。如果确定癌症可切除，腹腔镜腹会阴联合切除术通常是首选治疗方法。然而，复杂的肛瘘癌往往需要广泛切除。在这种情况下，切除后使用肌皮瓣进行重建，无论肛瘘癌的大小如何，均可进行根治性切除。
病例报告
我们报告两例广泛肛瘘癌患者，行腹腔镜腹会阴联合切除术、广泛臀部切除及肌皮瓣重建。其中1例采用股后皮瓣重建，另1例采用双侧臀大肌扩张皮瓣重建。两例均为复杂性肛瘘发展而来的肛瘘癌。
结论
如果肛瘘癌体积较大且需要广泛臀部切除，在扩大的腹会阴联合切除术后使用肌皮瓣重建，有可能对肛瘘癌进行根治性切除。
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