腹腔镜慢性放射性直肠乙状结肠损伤晚期并发症切除手术策略  

Laparoscopic surgical resection strategy for late complications of radiation-induced late rectosigmoid injury

作　　者：周佐霖 黄斌杰[2,3] 何炎炯 秦启元 马腾辉[2,3] Zhou Zuolin;Huang Binjie;He Yanjiong;Qin Qiyuan;Ma Tenghui(Department of Colorectal Surgery,The Second People’s Hospital of Shenzhen(The First Affiliated Hospital of Shenzhen University),Shenzhen 518035,Guangdong,China;Department of General Surgery(Division of Colorectal Surgery,Radiation Intestinal Injury Center),The Sixth Affiliated Hospital of Sun Yat-sen University/Guangdong Key Laboratory for Colorectal and Pelvic Floor Diseases/Huangpu District Bio-medical Innovation Research Institute,Guangzhou 510655,Guangdong,China;Department of Clinical Nutrition and Microecology,The Sixth Affiliated Hospital of Sun Yat-sen University,Guangzhou 510655,Guangdong,China;Department of Gastrointestinal Surgery,Cancer Hospital of the Chinese Academy of Medical Sciences,Shenzhen Hospital,Shenzhen 518116,Guangdong,China)

机构地区：[1]深圳市第二人民医院(深圳大学第一附属医院)肛肠外科,广东深圳518035 [2]中山大学附属第六医院普通外科(结直肠外科、放射性肠损伤中心)/广东省结直肠盆底疾病研究重点实验室/广州市黄埔区中六生物医学创新研究院,广东广州510655 [3]中山大学附属第六医院临床营养与微生态科,广东广州510655 [4]中国医学科学院肿瘤医院深圳医院胃肠外科,广东深圳518116

出　　处：《结直肠肛门外科》2025年第1期1-5,共5页Journal of Colorectal & Anal Surgery

基　　金：中山大学附属第六医院临床医学研究1010计划基金资助项目(1010CG〔2022〕-09、1010PY〔2020〕48)。

摘　　要：外科手术是慢性放射性直肠乙状结肠损伤晚期并发症的首选治疗方式。然而,由于盆腔高剂量放射性损伤、手术史、慢性感染等因素导致腹盆腔解剖结构层次紊乱、盆腔手术操作空间狭小,增加了放射性病变直肠乙状结肠切除手术的难度和手术并发症发生率。如何高效、高质量地完成放射性病变直肠乙状结肠切除手术,降低手术并发症的发生率,为结直肠外科术者所关注。目前,国内外鲜有文献详细介绍腹腔镜慢性放射性病变直肠乙状结肠损伤晚期并发症切除手术。笔者团队在临床实践中将“微创技术”“扩大切除”“损伤控制”等理念应用到手术中,降低了手术并发症的发生率,并总结经验,形成了程序化、易于掌握的手术操作流程。Surgery is the preferred treatment for late complications of radiation-induced late rectosigmoid injury.However,due to factors such as high-dose pelvic radiation injury,surgical history,and chronic infection can lead to disordered abdominal and pelvic anatomical layers and a narrow pelvic surgical space,increasing the difficulty of resection surgery for radiation-induced late rectosigmoid injury and the incidence of surgical complications.How to efficiently and effectively complete the resection surgery of radiation-induced late rectosigmoid injury and reduce the incidence of surgical complications is a concern for colorectal surgeons.At present,there are few literature on laparoscopic resection surgery for late complications of radiation-induced late rectosigmoid injury in domestic and international.Our team has applied the concepts of“minimally invasive technology”,“extended resection”and“damage control”to the surgery in clinical practice,reducing the incidence of surgical complications and summarizing the experience to form a procedural and easy-to-learn surgical operation process.

关 键 词：慢性放射性直肠乙状结肠损伤 直肠阴道瘘 直肠乙状结肠切除 手术治疗 腹腔镜 

分 类 号：R735.3[医药卫生—肿瘤]