Early colon cancer within a diverticulum treated by magnifying chromoendoscopy and laparoscopy
Early colon cancer within a diverticulum treated by magnifying chromoendoscopy and laparoscopy
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DOI：
10.3748/wjg.v16.i12.1545
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发表时间：
2010-03-28
影响因子：
4.3
通讯作者：
Tsujinaka, Yasunobu
中科院分区：
文献类型：
--
作者：
Fu, Kuang I.;Hamahata, Yukihiro;Tsujinaka, Yasunobu
我们报告一例独特的粘膜内癌的管状绒毛腺瘤产生于单一憩室。内镜下粘膜切除术（EMR）在腹腔镜的辅助下成功完成。一名71岁男性因黑黑和贫血入院。急诊结肠镜检查显示右侧结肠憩室病。然而，内窥镜检查不能准确地发现出血部位。在降结肠的单个憩室内发现扁平升高的息肉，放大色内镜显示IV型凹型，诊断为粘膜内癌。由于憩室反复出血，决定行右侧结肠切除术治疗，同时在腹腔镜辅助下EMR将憩室内息肉完全切除。虽然EMR后立即发现结肠穿孔，但穿孔在腔内用内膜闭合，并在腹腔镜下从浆膜侧修复。组织学上，切除的病变为粘膜内高分化腺癌，手术边缘无肿瘤。(C) 2010年白石登。版权所有。
We report a unique case of intramucosal carcinoma in a tubulovillous adenoma arising from a single diverticulum. Endoscopic mucosal resection (EMR) was carried out successfully and completely with the assistance of laparoscopy. A 71-year-old man was admitted to our hospital because of melena and anemia. Emergent colonoscopy showed diverticulosis in the right-sided colon. However, endoscopy could not exactly detect the bleeding site. A flat elevated polyp was found within a single diverticulum located in the descending colon and diagnosed as an intramucosal carcinoma, as magnifying chromoendoscopy revealed a type IV pit pattern. As his diverticular bleeding repeated, a right-sided hemicolectomy was decided for treatment, the polyp within the diverticulum was also completely removed by EMR with the assistance of laparoscopy. Although a colonic perforation was detected immediately after EMR, the perforation was closed with endoclips intraluminally and also repaired laparoscopically from the serosal side. Histologically, the resected lesion was an intramucosal well-differentiated adenocarcinoma and the surgical margin was free of tumor. (C) 2010 Baishideng. All rights reserved.