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患者男、51岁,因交替腹泻便秘、便血3个月入院。经直肠指诊及镜检:截石位 距肛缘5cm5～8点处有一3×2.5×2.5cm~3菜花状包块,较固定,表面坏死、溃烂。活检为管状腺癌。经术前准备后在持续硬膜外麻醉下行经腹会阴直肠切除、乙状结肠腹壁造口术。术中未见肝、腹主动脉及肠系膜下动脉周围淋巴结转移,肿瘤位于腹膜反折下
The patient was male, 51 years old. He was admitted to hospital for 3 months because of alternating diarrhea and constipation. Transrectal digital examination and microscopic examination: Stone lithotomy position 5cm from 5 to 8 points from the anal verge of a 3 × 2.5 × 2.5cm ~ 3 cauliflower mass, relatively fixed, surface necrosis, ulceration. Biopsy is tubular adenocarcinoma. After preoperative preparation, abdominal epiglottic rectal resection and sigmoid colon abdominal wall ostomy were performed under continuous epidural anesthesia. No lymph node metastasis was found in the liver, abdominal aorta, and inferior mesenteric artery during surgery. The tumor was located under peritoneal refraction.