经腹会阴联合直肠癌根治术后造口肿瘤并同时性肝转移1例报道及文献复习  

A case of stoma tumour with synchronous liver metastasis after transabdominal perineal radical resection for rectal cancer and review of literature

作　　者：李璇 陈钰榕 陈志强[2] 邹瞭南[3,4] Li Xuan;Chen Yurong;Chen Zhiqiang;Zou Liaonan(Postgraduate of the Second Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510120,Guangdong,China;Department of Urology Surgery,Guangdong Hospital of Traditional Chinese Medicine,Guangzhou 510120,Guangdong,China;Department of Anorectal Surgery,Guangdong Hospital of Traditional Chinese Medicine,Guangzhou 510120,Guangdong,China;The Second Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510120,Guangdong,China)

机构地区：[1]广州中医药大学第二临床医学院研究生,广东广州510120 [2]广东省中医院泌尿外科,广东广州510120 [3]广东省中医院肛肠外科,广东广州510120 [4]广州中医药大学第二临床医学院,广东广州510120

出　　处：《消化肿瘤杂志（电子版）》2024年第1期125-130,共6页Journal of Digestive Oncology(Electronic Version)

基　　金：国家区域中医(专科)诊疗中心建设专项资金资助(国中医药医政函(2018)205号广东省中医院外科)。

摘　　要：目的本文探讨异时性结肠造口处肿瘤的临床特点及诊治过程,为特殊部位的异时性结直肠癌的诊治提供临床经验。方法回顾性描述1例低位直肠癌经腹会阴联合切除术后10年,出现造口处肿瘤的临床病例,并进行相关文献复习。结果结合患者病史、症状、体征及辅助检查,考虑患者造口处肿瘤是由于造口护理不当、肠道分泌物及粪便反复污染刺激所致。患者的自身免疫系统疾病也是潜在病因。我们采取造口肿瘤及周围皮肤的根治性切除术,术后至2023年8月9日未见疾病进展征象。结论对于特殊部位的异时性结直肠癌,其诊疗方式更趋向于个体化,尚未能形成规范的治疗方案,定期规律监测随访是早发现早诊治的有效途径,是减少全身转移风险、提高R0切除机会的可靠方法。ObjectiveThis paper discusses the clinical characteristics and diagnostic and treatment process of tumours at metachronous colostomies to provide clinical experience for metachronous colorectal cancer at special sites.Method A clinical case of a patient presenting with tumour at the stoma 10 years after combined transabdominal perineal resection for low rectal cancer was retrospectively described,and relevant literature review was performed.Result Combining the patient's medical history,symptoms,signs and auxiliary examinations,it was considered that the tumours at the patient's stoma were due to improper stoma care and stimulation by repeated contamination with intestinal secretions and faeces.The patient's autoimmune system disease was also identified as a potential cause.Following the radical resection of the stoma tumours and surrounding skin,no signs of disease progression have been observed from post-operation to August 9,2023.Conclusion The diagnosis and treatment of metachronous colorectal cancer at special sites tends to be more individualised,and no standardised treatment plan has been formed yet.Regular monitoring and follow-up are effective ways for early detection and diagnosis and treatment,which is a reliable method to reduce the risk of systemic metastasis and improve the chance of R0 resection.

关 键 词：造口肿瘤 直肠癌根治术 异时性肿瘤 病例报道 

分 类 号：R735.37[医药卫生—肿瘤]