Scarless Two-Stage Delayed Coloanal Anastomosis: A Technique Description

Q4 Medicine Journal of Coloproctology Pub Date : 2022-10-19 DOI:10.1055/s-0043-1764166
Hani Bendib, Hind Oukrine, Nabil Djelali, Said Lahrech, Ameur Elbahi, Chemseddine Chekman, Abdelghani Azzouz, Abdelkrim Anou, Azeddine Djennaoui
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引用次数: 1

Abstract

Abstract Introduction  In current clinical practice, immediate coloanal anastomosis (ICA) remains the standard technique for restoring the gastrointestinal tract following coloproctectomy for low rectal cancer. This anastomosis still requires a temporary diverting stoma to decrease the postoperative morbidity, which remains significantly high. As an alternative, some authors have proposed a two-stage delayed coloanal anastomosis (TS-DCA). This article reports on the surgical technique of TS-DCA. Methods  The case described is of a 53-year-old woman, without any particular history, in whom colonoscopy motivated by rectal bleeding revealed an adenocarcinoma of the low rectum. Magnetic resonance imaging showed a tumor ∼ 1 cm above the puborectalis muscle, graded cT3N + . The extension workup was negative. Seven weeks after chemoradiotherapy, a coloproctectomy with total mesorectal excision (TME) was performed. A TS-DCA was chosen to restore the digestive tract. Conclusion  Two-stage delayed coloanal anastomosis is a safe and effective alternative for restoring the digestive tract after proctectomy for low rectal cancer. Recent data seem to show a clear advantage of this technique in terms of morbidity.
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无瘢痕两期延迟结肠肛管吻合术:一种技术描述
摘要简介 在目前的临床实践中,即时结肠直肠吻合(ICA)仍然是癌症结肠直肠切除术后恢复胃肠道的标准技术。这种吻合仍然需要一个临时的分流造口来降低术后的发病率,而术后发病率仍然很高。作为一种替代方案,一些作者提出了两阶段延迟结肠肛门吻合(TS-DCA)。本文报道TS-DCA的手术技术。方法 所描述的病例是一名53岁的女性,没有任何特殊病史,其直肠出血引起的结肠镜检查显示低位直肠腺癌。磁共振成像显示肿瘤~1 耻骨直肠肌上方cm,分级cT3N + . 分机检查结果为阴性。放化疗后7周,行结肠直肠切除术,并行全直肠系膜切除术(TME)。选择TS-DCA来恢复消化道。结论 低位癌症直肠切除术后二期延迟结肠直肠吻合是一种安全有效的恢复消化道的方法。最近的数据似乎显示了这种技术在发病率方面的明显优势。
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来源期刊
Journal of Coloproctology
Journal of Coloproctology Medicine-Gastroenterology
CiteScore
0.60
自引率
0.00%
发文量
41
审稿时长
47 weeks
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