作者：林晓聪1，陈昭宇2，易小江2，冯晓创2，廖伟林2，林佳鑫2，汪佳豪2，李洪明2，卢新泉2，刁德昌2

单位：1 中山市中医院 肛肠科，广东 中山 528401；2 广东省中医院胃肠肿瘤诊疗中心 结直肠外科， 广州中医药大学第二附属医院，广东 广州 510120

Authors: Lin Xiaocong1，Chen Zhaoyu2，Yi Xiaojiang2，Feng Xiaochuang2，,Liao Weilin2，Lin Jiaxin2，Wang Jiahao2，Li Hongming2，Lu Xinquan2，Diao Dechang2

Unit: 1.Department of Anorectal Surgery, Zhongshan Hospital of Traditional Chinese Medicine, Zhongshan 528401, Guangdong, China；2.Department of Colorectal Surgery, Gastrointestinal Cancer Center, Guangdong Provincial Hospital of Traditional Chinese Medicine, the Second Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine, Guangzhou 510120, Guangdong, China

摘要：

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。

关键词：腹腔镜；结直肠癌；吻合口瘘；坏死性筋膜炎

Abstract：

At present, there are many causes of necrotizing fasciitis, and occasional reports of necrotiz[1]ing 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.

Key Words: Laparoscopy；Colorectal cancer；Anastomotic leakage；Necrotizing fasciitis