腹腔镜结直肠癌术后吻合口瘘合并坏死性筋膜炎2例报道及文献回顾

Anastomotic leakage complicated with necrotizing fasciitis after laparoscopic colorectal cancer surgery:a report of 2 cases and literature review

目前,引起坏死性筋膜炎的病因较多,结直肠癌手术引起的坏死性筋膜炎也偶有报道,但腹腔镜结直肠癌术后吻合口瘘合并坏死性筋膜炎尚未见报道。本文报道病例1行腹腔镜右半结肠扩大根治术联合乙状结肠癌根治术,病例2行腹腔镜直肠癌根治术,术后均出现后吻合口瘘合并坏死性筋膜炎,预后各异。回顾2例患者的诊疗经过并进行文献复习,经验总结早期诊断和及时手术干预对预后尤为关键,治疗手段主要包括肠道的转流术和坏死组织清创术。

At present,there are many causes of necrotizing fasciitis,and occasional reports of necrotizing fasciitis caused by colorectal cancer surgery.However,there is no report of anastomotic leakage complicated with necrotizing fasciitis after laparoscopic colorectal cancer surgery.This article reports that case 1 underwent laparoscopic radical right hemicolectomy combined with sigmoid colectomy,and case 2 underwent laparoscopic radical operation for rectal cancer.Postoperative anastomotic leakage complicated with necrotizing fasciitis occurred in both cases,with different prognosis.The diagnosis and treatment of these two patients were and literature was reviewed.The experience was summarized that early diagnosis and timely surgical intervention were particularly critical to the prognosis.The treatment methods mainly included intestinal bypass and necrotic tissue debridement.