Yamamoto Seiya, Fujii Yoshiaki, Kurimoto Masaaki, Takahashi Hiroki, Sawai Hirozumi, Takiguchi Shuji
Department of Gastroenterological Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi 467-8601, Japan.
Department of Gastroenterological Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi 467-8601, Japan.
Int J Surg Case Rep. 2025 Aug 18;135:111839. doi: 10.1016/j.ijscr.2025.111839.
The incidence of anterior enterocele following robotic radical cystectomy is reported to be approximately 3 %, making it a rare complication. We experienced a case in which a patient developed an anterior enterocele and strangulated ileus through the urethral excision site, for which intracorporeal anastomosis proved to be an effective treatment under a specific and limited clinical situation.
A 72-year-old woman underwent a robot- assisted radical cystectomy for bladder cancer. At nine months post-operation, she presented with small bowel evisceration resulting from dehiscence of an anterior enterocele accompanied by strangulated ileus. Laparoscopic small bowel resection with intracorporeal anastomosis (IA) was performed. Oral intake of food was resumed on post-operative day 3, and the patient was discharged without complications on post-operative day 10.
In cases of strangulated ileus with dilated bowel loops, minimally invasive surgery incorporating IA can be safely performed by temporarily utilizing an intestinal bulldog clamp for the bowel, employing indocyanine green fluorescence imaging, and selecting an appropriate anastomotic technique. If an adequate surgical environment is maintained, IA may be a viable option for the treatment of strangulated ileus.
IA may be a viable option for treating strangulated ileus in a limited situation.
据报道，机器人根治性膀胱切除术后前肠膨出的发生率约为3%，使其成为一种罕见的并发症。我们遇到一例患者，其通过尿道切除部位发生了前肠膨出并伴有绞窄性肠梗阻，在特定且有限的临床情况下，体内吻合术被证明是一种有效的治疗方法。
一名72岁女性因膀胱癌接受了机器人辅助根治性膀胱切除术。术后九个月，她因前肠膨出裂开并伴有绞窄性肠梗阻而出现小肠脱出。进行了腹腔镜小肠切除并体内吻合（IA）。术后第3天恢复经口进食，患者在术后第10天无并发症出院。
在伴有肠袢扩张的绞窄性肠梗阻病例中，通过临时使用肠压榨钳夹闭肠管、采用吲哚菁绿荧光成像并选择合适的吻合技术，可以安全地进行包含IA的微创手术。如果维持了足够的手术环境，IA可能是治疗绞窄性肠梗阻的一个可行选择。
在有限的情况下，IA可能是治疗绞窄性肠梗阻的一个可行选择。
