低位直肠癌TME术后吻合口复发再次行完全ISR手术1例报道  

Complete ISR for Anastomotic Recurrence after TME in Low Rectal Cancer:A Case Report and Discussion of Distal Margin

作　　者：郭昌 吕智豪 赵文韬[1,2] 胡丰良[1,2] GUO Chang;LYU Zhi-hao;ZHAO Wen-tao;HU Feng-liang(First School of Clinical Medicine,Guangzhou University of TCM Traditional Chinese Medicine,Guangzhou 510405,Guangdong,China;the First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine,Guangzhou 510405,Guangdong,China)

机构地区：[1]广州中医药大学第一临床医学院,广东广州510405 [2]广州中医药大学第一附属医院,广东广州510405

出　　处：《中国现代手术学杂志》2020年第6期411-415,共5页Chinese Journal of Modern Operative Surgery

基　　金：广州市科技计划项目(201709010019)。

摘　　要：目的报道1例低位直肠癌全系膜切除术(total mesorectal excision,TME)术后吻合口复发,行完全经括约肌间切除术(intersphicteric resection,ISR)的患者,探讨其复发原因及补救措施。方法2019年9月我院收治1例低位直肠癌TME术后吻合口复发的患者,再次行完全ISR术,现整理其临床资料,总结相关经验,并结合文献复习术后复发的原因及治疗方法。结果该患者术后吻合口复发的原因可能与下切缘距离不够有关,再次行完全ISR手术,效果满意。结论对于低位直肠癌下切缘距离问题,目前尚无定论,但大部分文献建议下切缘应大于2 cm。对于低位直肠癌吻合口复发患者,符合手术适应证时可行ISR手术进行R0切除。Objective To report a patient who underwent complete ISR for anastomotic recurrence following low rectal cancer TME resection,and to explore the causes and remedies for the recurrence.Methods The clinical data of the patient who underwent complete ISR after anastomotic recurrence following low rectal cancer TME resection were retrospectively analyzed.Relevant experience was summarized,and the causes and treatments of the anastomotic recurrence of low rectal cancer were reviewed in combination with literature.Results The reason for the recurrence of anastomosis in this patient may be related to the distance of the lower resection margin.And the anastomosis of low rectal cancer in this patient was reissued with complete ISR surgery with satisfactory results.Conclusion As for the distance of the lower resection margin of rectal cancer,no conclusion has been reached.However,most literature suggests that the lower resection margins should be larger than 2cm,and it is feasible to perform R0 resection by ISR surgery for the anastomotic recurrence of low rectal cancer.

关 键 词：低位直肠肿瘤 经括约肌间切除术 吻合口复发 

分 类 号：R735.37[医药卫生—肿瘤]