肠道子宫内膜异位症12例临床分析  

Diagnosis and treatment of intestinal endometriosis:report of 12 cases

作　　者：宋世铎[1] 王超[2] 唐悠远 朱新国[1] Song Shiduo;Wang Chao;Tang Youyuan;Zhu Xinguo(Department of General Surgery,the First Affiliated Hospital of Soochow University,Suzhou 215006,China;Department of Gastroenterology,the First Affiliated Hospital of Soochow University,Suzhou 215006,China)

机构地区：[1]苏州大学附属第一医院普通外科,苏州215006 [2]苏州大学附属第一医院消化内科,苏州215006

出　　处：《中华普通外科杂志》2024年第1期41-44,共4页Chinese Journal of General Surgery

摘　　要：目的探讨肠道子宫内膜异位症的诊断和处理方法。方法回顾性分析2016年8月至2023年1月期间苏州大学附属第一医院诊断肠道子宫内膜异位症12例患者的临床资料。结果 12例患者中直肠子宫内膜异位症8例,乙状结肠子宫内膜异位症3例,回肠子宫内膜异位症1例。行肠镜检查9例,CT检查6例,MRI检查3例,经腹或阴道超声检查4例。12例均接受手术治疗,8例拟诊结直肠肿瘤行肠切除手术;1例位于回肠无法明确病理性质且靠近回盲部,行右半结肠切除术;2例为妇科手术中发现肠道子宫内膜异位症,行肠管局部切除术;1例为经肛切除肿块,经术后病理证实。5例为开腹手术,5例为腹腔镜手术,1例为机器人手术,1例为经肛门手术。7例为2次以上手术,最多1例共行5次手术。住院时间为9~351 d。12例均治愈,随访至今无复发。结论肠道子宫内膜异位症在术前难以明确诊断,极易误诊为结直肠肿瘤,应重视腹腔镜探查及术中快速病理检查的作用。Objective To explore the diagnosis and treatment of intestinal endometriosis.Methods The clinical data of 12 patients with intestinal endometriosis at the First Affiliated Hospital of Soochow University from Aug 2016 to Jan 2023 were retrospectively analyzed.Results There were 8 cases of rectal endometriosis,3 cases of sigmoid colon endometriosis and 1 case of ileal endometriosis.Nine cases underwent colonoscopy,6 cases underwent CT examination,3 cases underwent MRI examination,and 4 cases underwent transabdominal or vaginal ultrasnography.All 12 cases underwent operation,8 cases were misdiagnosed as colorectal neoplasms and underwent intestinal resection,1 case had right hemicolectomy because of ambiguous pathology,2 cases with definite intestinal endometriosis underwent local intestinal resection,1 case had transanal tumor excision with diagnosis confirmed by postoperative pathology;5 cases underwent open surgery,5 cases did laparoscopy,1 case was done with robotic surgery,1 case was by transanal surgery;7 patients underwent more than 2 surgeries,with a maximal of 5 surgeries in one case.The hospital stay varied from 9 to 351 days,all 12 cases were cured,and follow-up found no recurrence.Conclusions It is often difficult to make a clear diagnosis of intestinal endometriosis preoperatively.Many were misdiagnosed as colorectal neoplasms.Laparascopic exploration and biopsy help prevent inappropriate surgery.

关 键 词：子宫内膜异位症 并发症 手术后 

分 类 号：R711.71[医药卫生—妇产科学]