1例放射性小肠瘘患者采用膀胱腹膜瓣进行盆底腹膜重建的病例报告  

Pelvic peritoneal reconstruction using the bladder peritoneum flap in a patient with radiation-induced small intestinal fistula

作　　者：薛达 王海滨 穆林松[1] 吕忠船[1] 胡志军 Xue Da;Wang Haibin;Mu Linsong;LüZhongchuan;Hu Zhijun(Department of General Surgery,Yantai Yuhuangding Hospital,Yantai 264000,Shandong,China)

机构地区：[1]烟台毓璜顶医院普通外科,山东烟台264000

出　　处：《结直肠肛门外科》2025年第1期73-76,共4页Journal of Colorectal & Anal Surgery

摘　　要：直肠癌术后形成的盆底腹膜缺损、盆腔残腔容易使患者出现相关的手术并发症,如肠梗阻、疝、感染。若腹腔内的肠管坠入盆腔,可能增加术后放射治疗相关的放射性肠炎的发生率。盆底腹膜重建有助于减少上述现象,但是复杂条件下的盆底腹膜重建成功率通常不高。笔者团队收治了1例接受直肠癌综合治疗(腹会阴联合切除术、化学治疗、放射治疗)后的患者,其就诊时出现小肠瘘,存在盆腔感染,而且后续可能接受放射治疗。笔者团队对该患者采用膀胱腹膜瓣进行盆底腹膜重建,取得较好的短期手术疗效。Postoperative pelvic peritoneal defects and pelvic residual cavity after rectal cancer surgery are prone to cause related surgical complications,such as intestinal obstruction,hernia,and infection.If the intestines in the abdominal cavity prolapse into the pelvic cavity,the incidence of radiation enteritis related to postoperative radiotherapy may increase.Pelvic peritoneal reconstruction can help reduce the occurrence of the phenomena mentioned above,but the success rate of pelvic peritoneal reconstruction under complex conditions is usually not high.Our team treated a patient with rectal cancer who had undergone comprehensive treatment,including abdominoperineal resection,chemotherapy,and radiotherapy.The patient presented with a small intestinal fistula and pelvic infection at the time of consultation and might receive radiotherapy subsequently.Our team performed pelvic peritoneal reconstruction using the bladder peritoneum flap in this patient and achieved good short-term surgical outcomes.

关 键 词：直肠癌 腹会阴联合切除术 化学治疗 放射治疗 小肠瘘 盆底腹膜重建 膀胱腹膜瓣 

分 类 号：R735.3[医药卫生—肿瘤]