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肺移植后因囊性纤维化出现巨大扁平湿疣:采用带黏膜桥的环形痔切除术成功治疗

Massive anal condyloma lata following lung transplantation due to cystic fibrosis: successful treatment with circular hemorrhoidectomy with mucosal bridges.

作者信息

Niedritis Arturs, Lebedjkovs Sergejs

机构信息

Riga Stradins University, Faculty of Medicine, Dzirciema iela 16, Riga 1007, Latvia.

Department of General Surgery, AIWA Clinic, Maskavas iela 241, Riga 1063, Latvia.

出版信息

J Surg Case Rep. 2024 Nov 15;2024(11):rjae690. doi: 10.1093/jscr/rjae690. eCollection 2024 Nov.

DOI:10.1093/jscr/rjae690
PMID:39554384
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11567738/
Abstract

This case report presents the treatment of a 36-year-old male patient with massive anal condyloma lata following lung transplantation due to cystic fibrosis. The patient, under long-term immunosuppressive therapy, developed extensive wart-like lesions around the anal canal. A modified circular hemorrhoidectomy with mucosal bridges was performed to excise the affected tissue while preserving functional integrity. The surgery, conducted under general anesthesia, successfully removed all lesions without complications. Postoperatively, the patient experienced no pain, bleeding, incontinence, or recurrence during follow-up. The preservation of mucosal bridges helped prevent common complications such as anal stenosis and mucosal ectropion. Histology confirmed the diagnosis of condyloma lata. This case underscores the effectiveness of circular hemorrhoidectomy, particularly in patients with circular anal canal lesions, and highlights the role of mucosal bridges in minimizing postoperative complications while ensuring complete lesion excision. This technique should be considered in similar cases of extensive anal lesions.

摘要

本病例报告介绍了一名36岁男性囊性纤维化患者肺移植术后发生巨大扁平湿疣的治疗情况。该患者长期接受免疫抑制治疗,在肛管周围出现广泛的疣状病变。采用改良的带黏膜桥的环形痔切除术切除病变组织,同时保留功能完整性。手术在全身麻醉下进行,成功切除所有病变,无并发症发生。术后随访期间,患者无疼痛、出血、失禁或复发情况。保留黏膜桥有助于预防肛门狭窄和黏膜外翻等常见并发症。组织学检查确诊为扁平湿疣。本病例强调了环形痔切除术的有效性,特别是对于肛管环形病变患者,并突出了黏膜桥在确保完全切除病变的同时将术后并发症降至最低方面的作用。对于类似的广泛肛门病变病例,应考虑采用该技术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f4fe/11567738/d4095bc1f813/rjae690f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f4fe/11567738/6615cd305915/rjae690f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f4fe/11567738/211085b5dc3d/rjae690f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f4fe/11567738/d4095bc1f813/rjae690f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f4fe/11567738/6615cd305915/rjae690f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f4fe/11567738/211085b5dc3d/rjae690f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f4fe/11567738/d4095bc1f813/rjae690f3.jpg

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本文引用的文献

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Modified whitehead hemorrhoidectomy versus partial hemorrhoidectomy for fourth-degree circular mixed hemorrhoids: A retrospective analysis.改良Whitehead痔切除术与部分痔切除术治疗环状Ⅳ度混合痔的回顾性分析
Heliyon. 2024 Mar 20;10(7):e28465. doi: 10.1016/j.heliyon.2024.e28465. eCollection 2024 Apr 15.
2
International Anal Neoplasia Society's consensus guidelines for anal cancer screening.国际肛门肿瘤学会肛门癌筛查共识指南。
Int J Cancer. 2024 May 15;154(10):1694-1702. doi: 10.1002/ijc.34850. Epub 2024 Jan 31.
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The Surgical Treatment of Haemorrhoids.
痔疮的外科治疗
Br Med J. 1882 Feb 4;1(1101):148-50. doi: 10.1136/bmj.1.1101.148.
4
An anorectoplasty for extensive and complicated hemorrhoids.针对广泛且复杂痔疮的肛门直肠成形术。
Surgery. 1953 Jul;34(1):72-87.
5
Radio frequency "sutureless" fistulotomy- a new way of treating fistula in anus.射频“无缝合”肛瘘切开术——一种治疗肛瘘的新方法。
World J Gastroenterol. 2003 May;9(5):1082-5. doi: 10.3748/wjg.v9.i5.1082.