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患者:男,62岁。因腹泻、便秘反复交替,便血,左下腹痛3月,按慢性结肠炎治疗无效,经结肠镜检查诊断为乙状结肠癌而收入院。一般情况较差,BP14/10kPa,腹平软,左下腹有压痛。无反跳痛,无包块。术前胸透和肝脏B超及心电图检查结果正常。于1989年11月18日手术,术中见乙状结肠中段有4×5×6cm大小肿块,与周围有粘连。肿块上段结肠扩张呈肠梗阻表现,肿块周围淋巴结无肿大,肝脏未见转移征象。行降结肠中、下段,乙状结肠、直肠上段及其系膜切除;同时清扫乙状结肠淋巴结/左结肠淋巴结,肠系膜下动脉周围淋巴结,行降结肠上段与直肠端端吻合术。术后组织病理检查诊断为乙状结肠类癌。术后第13天发现吻合口瘘,经治疗痊愈出院,随访半年无复发。讨论;类癌为一种少见肿瘤。据国外资料分
Patient: Male, 62 years old. Due to diarrhea, constipation, alternating, blood in the stool, left lower abdominal pain in March, according to chronic colitis ineffective treatment, colonoscopy diagnosis of sigmoid colon cancer and income hospital. The general situation is poor, BP14/10kPa, abdomen soft, with tenderness in the left lower quadrant. No rebound pain, no mass. Preoperative chest and liver B-ultrasound and ECG results were normal. Surgery was performed on November 18, 1989. During the operation, there was a 4×5×6 cm mass in the middle segment of the sigmoid colon, and there was adhesion around it. The upper segment of the mass was dilated and showed intestinal obstruction. No lymph nodes around the mass were swollen. There was no sign of metastasis in the liver. The descending segment of the colon, the lower sigmoid, the sigmoid, the upper rectum, and the mesenterium were removed. At the same time, the sigmoid lymph node/left colon lymph node and the lymph nodes around the inferior mesenteric artery were removed. The anastomosis of the upper segment of the descending colon and the rectum was performed. Histopathological examination after the diagnosis of sigmoid colon cancer. Anastomotic fistula was found on the 13th day after operation. He was discharged after treatment and no recurrence occurred during the follow-up period of six months. Discussion; carcinoid is a rare tumor. According to foreign data points