内容紹介
Summary
We report a case of appendicitis with an abscess that was treated with single-incision laparoscopic ileocecal resection with D2 lymphadenectomy because of intraoperative suspicion of appendiceal cancer. A 73-year-old woman was admitted to the hospital because of right lower abdominal pain. She was diagnosed with appendicitis with an abscess. Although single-incision laparoscopic appendectomy was planned, appendiceal cancer was suspected from intraoperative findings. Therefore, we performed single-incision laparoscopic ileocecal resection with D2 lymphadenectomy. The pathological result was moderately differentiated adenocarcinoma in the appendix. Because of the high risk of fStageⅡ appendiceal cancer, adjuvant chemotherapy was administered. Neither recurrence nor metastasis have been detected 7 months after surgery.
要旨
症例は73歳,女性。右下腹部痛で近医を受診し,虫垂炎を疑われ当院紹介となった。腹部造影CT検査で膿瘍を伴う虫垂炎の診断で同日緊急手術を施行した。術中所見では白色調の虫垂と回盲部の膿瘍形成を認めたため,虫垂癌も念頭に置き,単孔式腹腔鏡下回盲部切除術+D2リンパ節郭清術を施行した。 術後病理結果は中分化型腺癌で,病期はfStageⅡであった。術後経過は良好で術後第11病日に退院となった。術後補助化学療法を施行し,術後7か月目の現在まで無再発生存中である。膿瘍を伴う虫垂炎の術前診断で術中に虫垂癌を疑い,単孔式腹腔鏡下にて回盲部切除術を施行した症例を経験したので,若干の文献的考察を加え報告する。
目次
We report a case of appendicitis with an abscess that was treated with single-incision laparoscopic ileocecal resection with D2 lymphadenectomy because of intraoperative suspicion of appendiceal cancer. A 73-year-old woman was admitted to the hospital because of right lower abdominal pain. She was diagnosed with appendicitis with an abscess. Although single-incision laparoscopic appendectomy was planned, appendiceal cancer was suspected from intraoperative findings. Therefore, we performed single-incision laparoscopic ileocecal resection with D2 lymphadenectomy. The pathological result was moderately differentiated adenocarcinoma in the appendix. Because of the high risk of fStageⅡ appendiceal cancer, adjuvant chemotherapy was administered. Neither recurrence nor metastasis have been detected 7 months after surgery.
要旨
症例は73歳,女性。右下腹部痛で近医を受診し,虫垂炎を疑われ当院紹介となった。腹部造影CT検査で膿瘍を伴う虫垂炎の診断で同日緊急手術を施行した。術中所見では白色調の虫垂と回盲部の膿瘍形成を認めたため,虫垂癌も念頭に置き,単孔式腹腔鏡下回盲部切除術+D2リンパ節郭清術を施行した。 術後病理結果は中分化型腺癌で,病期はfStageⅡであった。術後経過は良好で術後第11病日に退院となった。術後補助化学療法を施行し,術後7か月目の現在まで無再発生存中である。膿瘍を伴う虫垂炎の術前診断で術中に虫垂癌を疑い,単孔式腹腔鏡下にて回盲部切除術を施行した症例を経験したので,若干の文献的考察を加え報告する。