- 期刊
Single-incision Plus One-port Laparoscopic Sigmoidectomy in Situs Inversus Totalis: A Case Report and Literature Review
完全器官轉位病患接受單切口外加一孔之腹腔鏡乙狀結腸切除術之案例分享：病例報告及文獻回顧
摘要
Situs inversus totalis (SIT) is a rare congenital autosomal recessive hereditary disease characterized by complete inversion of the thoracic and abdominal viscera. As a result, surgical procedures are considered more difficult in patients with SIT owing to the mirrored image of the anatomy, especially in laparoscopic surgery. Herein, we report a case of SIT in a patient diagnosed with sigmoid colon cancer, that was treated with single-incision plus one-port laparoscopic sigmoidectomy. The patient was discharged on post-operative day 5 without any complication. Single-incision plus one-port laparoscopic anterior resection for SIT patient with colorectal cancer is safe and feasible when performed by a skilled surgeon with fully understanding of the anatomy.
並列摘要
完全性器官逆位是一種少見的自體隱性遺傳疾病，胸腔及腹腔內的器官完全左右相反，呈現鏡像的表現。因此在臨床上疾病診斷及外科手術上伴隨相當程度的困難，尤其是在微創的腹腔鏡手術方面由是如此。我們在此分享一位五十七歲男性，因排便習慣改變及血便等徵象求診，進一步大腸鏡檢查則發現乙狀結腸處一巨大腫瘤，切片檢查顯示為腺癌。在經過後續單切口外加一孔之腹腔鏡乙狀結腸切除，術後逐漸恢復正常活動及進食。臨床上無特殊併發症，於術後五天順利出院。以這樣的病例而言，手術上困難的不只是單孔腹腔鏡手術空間上的限制，病人本身肥胖體型也對手術的時間存在影響。不過，在此我們認為，完全性器官逆轉位患者在接受手術上，經由完整術前評估及仔細影像上的規劃，由有經驗的外科醫師執行腹腔鏡手術是相對安全且適合的治療方式。
參考文獻
延伸閱讀
- Kao, S. H., Feng, I. J., Jen, L. C., Chen, H. K., Lin, Y. F., Wang, W. C., Yan, C. S., Sun, D. P., Chen, M. J., Tian, Y. F., & Chou, C. L. (2020). 同時切除針對可手術切除的大腸癌合併肝轉移的患者，比較剖腹手術及腹腔鏡手術的成果：奇美醫院的經驗. 中華民國大腸直腸外科醫學會雜誌, 31(3), 134-141. https://doi.org/10.6312/SCRSTW.202009_31(3).10901
- Chen, C. I., Wang, H. M., Chiang, F. F., & Chen, M. C. (2011). 腹腔鏡右側大腸切除手術之早期經驗：單一醫療機構之分析. 中華民國大腸直腸外科醫學會雜誌, 22(1), 13-19. https://doi.org/10.6312/SCRSTW.2011.22(1).09913
- Chin, C. C., Yeh, C. Y., & Wang, J. Y. (2004). 對於非常低位之直腸癌，以腹部肛門切除併結腸J-Pouch肛門吻合術與腹部會陰切除術之臨床結果的比較. 中華民國大腸直腸外科醫學會雜誌, 15(1), 17-22. https://doi.org/10.6312/SCRSTW.2004.15(1).09303
- Feng, W. F., Chou, A. L., Tzeng, J. E., & Tseng, K. C. (2006). 在內視鏡下使用食道靜脈瘤結紮器切除直腸類癌一病例報告及文獻迴顧. 內科學誌, 17(1), 28-32. https://doi.org/10.6314/JIMT.2006.17(1).05
- Ho, C. L., Chang, S. C., Ke, T. W., Chen, H. C., Tsai, Y. Y., Hsieh, M. H., Chen, Y. C., Huang, C. W., Chang, W. R., Wang, H. M., & Chen, W. T. L. (2022). 腫瘤減積手術加腹腔內熱化療治療大腸直腸癌、闌尾癌併發腹膜轉移病患：中國醫藥大學附設醫院經驗分享. 中華民國大腸直腸外科醫學會雜誌, 33(3), 145-155. https://doi.org/10.6312/SCRSTW.202209_33(3).11113