Yamazaki T, Shirai Y, Sakai Y, Hatakeyama K
First Department of Surgery, Niigata University School of Medicine, Japan.
Surg Today. 1997;27(3):254-6. doi: 10.1007/BF00941656.
Despite Sudeck's cautionary report regarding the risk of colon necrosis following a pull-through procedure, published in 1907, most colorectal surgeons do not pay close attention to Sudeck's critical point when operating in the rectosigmoid region. We report herein the case of a patient who developed an ischemic stricture, 6 cm in length, in the rectosigmoid colon distal to the anastomosis following a radical sigmoidectomy with division of the superior rectal artery immediately distal to Sudeck's point. This is the first documentation of a patient developing an ischemic stricture attributable to sigmoidectomy. Division of the artery distal to Sudeck's point most probably impaired the blood supply to the rectosigmoid colon, which subsequently resulted in occlusive ischemic colitis. Thus, there is a risk that division of the superior rectal artery distal to Sudeck's point may lead to colonic ischemia in the remaining rectosigmoid region following sigmoidectomy.
尽管1907年苏德克（Sudeck）发表了关于拖出术（pull-through procedure）后结肠坏死风险的警示报告，但大多数结直肠外科医生在直肠乙状结肠区域进行手术时，并未密切关注苏德克的关键要点。我们在此报告一例患者，在距苏德克点（Sudeck's point）远侧立即切断直肠上动脉的根治性乙状结肠切除术后，吻合口远侧的直肠乙状结肠出现了一段6厘米长的缺血性狭窄。这是首例记录因乙状结肠切除术导致缺血性狭窄的患者。在苏德克点远侧切断动脉很可能损害了直肠乙状结肠的血液供应，随后导致闭塞性缺血性结肠炎。因此，在乙状结肠切除术后，在苏德克点远侧切断直肠上动脉可能会导致剩余直肠乙状结肠区域出现结肠缺血。
