腹腔镜在放射性直肠炎中的作用:病例报告及文献复习

A. Babu, Ankit Raikhy, S. K. Choudhary, A. Bhartia, V. Bhartia
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摘要

导言:放射性直肠炎是骨盆放射治疗后常见的并发症。放射性直肠炎分为急性和慢性。除4级慢性放射性直肠炎外,大多数病例均采取保守治疗,需要积极的手术治疗。以前这些手术是通过传统的开放技术完成的。随着微创手术的发展,现在有可能通过腹腔镜方法进行这些手术。病例介绍:我们在此报告一例75岁男性患者,其表现为深色血混合便通过,并伴有下坠、疼痛和腹泻。患者有因良性前列腺肥大行经尿道前列腺切除术的手术史。标本组织诊断为前列腺腺癌。患者于9个月前因前列腺癌接受放疗。结肠镜检查提示严重的远端直肠直肠炎,腹腔镜下行部分乙状结肠切除术和永久乙状结肠造口术。结论:腹腔镜在慢性放射性直肠炎的治疗中具有明确的作用,使患者受益于微创手术。
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Role of Laparoscopy in Radiation Proctitis: Case Report and Review of Literature
Introduction: The radiation proctitis is a known complication following the pelvic radiation therapy. Radiation proctitis is categorized as acute and chronic. Most of the cases are managed conservatively except in grade four chronic radiation proctitis, which active surgical management is needed. Previously these surgeries were done by conventional open technique. With the evolution of minimal access surgery it has now possible to do these surgeries by laparoscopic methods. Case Presentation: We here by present a case of 75 year old male patient presented with passage of dark colored blood mixed stools with tenesmus, pain and diarrhea. Patient had surgical history of transurethral resection of the prostrate (TURP) done for Benign Prostatic Hypertrophy. The tissue diagnosis of specimen was adenocarcinoma of prostate. Patient had received radiotherapy 9 months back for that prostatic carcinoma. The colonoscopy was suggestive of severe distal rectal proctitis, which was managed by laparoscopic proctectomy with partial sigmoidectomy and permanent end sigmoid colostomy. Conclusions: Laparoscopy has definitive role in management of chronic radiation proctitis, blessing the patient with benefits of minimal access surgery.
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