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中华结直肠疾病电子杂志 ›› 2023, Vol. 12 ›› Issue (04) : 342 -347. doi: 10.3877/cma.j.issn.2095-3224.2023.04.012

造口癌专栏

腹会阴联合直肠切除术后结肠造口癌一例
夏文豪, 吴作友, 张飞鸿, 黄平()   
  1. 211166 南京医科大学附属逸夫医院结直肠肛门外科
    211166 南京医科大学附属逸夫医院结直肠肛门外科;221000 南京医科大学第一附属医院结直肠肛门外科
  • 收稿日期:2023-02-14 出版日期:2023-08-25
  • 通信作者: 黄平

Adenocarcinoma occurring at a colostomy site after abdominoperineal resection for rectal carcinoma: a case report

Wenhao Xia, Zuoyou Wu, Feihong Zhang, Ping Huang()   

  1. Department of Colorectal and Anal Surgery, Sir Run Run Hospital, Nanjing Medical University, Nanjing 211166, China
    Department of Colorectal and Anal Surgery, Sir Run Run Hospital, Nanjing Medical University, Nanjing 211166, China; Department of Colorectal and Anal Surgery, the First Affiliated Hospital of the Nanjing Medical University, Nanjing 221000, China
  • Received:2023-02-14 Published:2023-08-25
  • Corresponding author: Ping Huang
引用本文:

夏文豪, 吴作友, 张飞鸿, 黄平. 腹会阴联合直肠切除术后结肠造口癌一例[J]. 中华结直肠疾病电子杂志, 2023, 12(04): 342-347.

Wenhao Xia, Zuoyou Wu, Feihong Zhang, Ping Huang. Adenocarcinoma occurring at a colostomy site after abdominoperineal resection for rectal carcinoma: a case report[J]. Chinese Journal of Colorectal Diseases(Electronic Edition), 2023, 12(04): 342-347.

腹会阴联合直肠切除术后在结肠造口部位的腺癌非常罕见,本中心报道了1例62岁的女性在腹会阴联合直肠癌根治性切除术后26年在结肠造口部位出现腺癌的病例,因患者有家族性息肉病,肠镜提示全结肠多发腺瘤性息肉,本中心手术切除了全部结肠以及完整的造口肿瘤及周围广泛腹壁,并行右下腹小肠造口。虽然造口癌很罕见,但需要警惕造口术后患者有发生造口癌的风险,有必要更加仔细地观察造口,以及完善结肠镜等检查以进行监测。

Adenocarcinoma occurring at a colostomy site after abdominoperineal resection for rectal carcinoma is very rare. We report a 62-year-old female who developed adenocarcinoma at the colostomy site 26 years after abdominoperineal resection for rectal carcinoma. Because the patient had familial adenomatous polyposis, enteroscopy showed multiple adenomatous polyps of the whole colon. We surgically removed all the colon, the complete stomal tumor and the surrounding extensive abdominal wall, The right lower abdominal enterostomy was performed. Although stoma cancer is rare, it is necessary to be alert to the risk of stoma cancer in patients after stoma operation. It is necessary to observe stoma more carefully and improve colonoscopy and other examinations for monitoring.

表1 既往文献中报道的16例造口癌病例
图1 结肠造口处肿块
图2 库克补片修补
图3 腹壁转移皮瓣修补
图4 手术后腹壁外观
图5 滚轴刀取刃厚游离皮片
图6 植皮于腹壁缺损处
图7 术后病理
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