内容紹介
Summary
A 65-year-old man with sigmoid colon cancer underwent sigmoidectomy, followed by 8 courses of oral S-1 as postoperative adjuvant chemotherapy. Three years and 3 months after surgery, the patient developed liver metastasis, lymphadenopathy at the root of the inferior mesenteric artery, and bilateral hydronephrosis. The left hydronephrosis was believed to be due to invasion by lymph node metastasis at the root of the inferior mesenteric artery. The patient underwent laparoscopic partial resection of segment 5 of the liver, excision of the lymph nodes at the root of the inferior mesenteric artery(combined resection of the left ureter), bilateral ureteral stent placement, and left ureteral reconstruction. The postoperative course was without complications, and he was discharged 12 days after surgery. Follow-up observation without postoperative adjuvant chemotherapy was planned, according to the patient's wishes.
要旨
症例は65歳,男性。 S状結腸癌に対し腹腔鏡下S状結腸切除術を施行され,術後補助化学療法としてS-1内服を8コース施行された。術後3年3か月で肝転移および下腸間膜動脈(IMA)根部リンパ節腫大と両側水腎症を認めた。左水腎症の原因はIMA根部リンパ節転移の浸潤によるものと考えられた。腹腔鏡下肝S5部分切除術・IMA根部リンパ節切除術(左尿管合併切除)・両側尿管ステント留置・左尿管再建術を施行した。合併症なく経過し,術後12日目に退院となった。本人の希望で術後補助化学療法は行わず経過観察中である。
目次
A 65-year-old man with sigmoid colon cancer underwent sigmoidectomy, followed by 8 courses of oral S-1 as postoperative adjuvant chemotherapy. Three years and 3 months after surgery, the patient developed liver metastasis, lymphadenopathy at the root of the inferior mesenteric artery, and bilateral hydronephrosis. The left hydronephrosis was believed to be due to invasion by lymph node metastasis at the root of the inferior mesenteric artery. The patient underwent laparoscopic partial resection of segment 5 of the liver, excision of the lymph nodes at the root of the inferior mesenteric artery(combined resection of the left ureter), bilateral ureteral stent placement, and left ureteral reconstruction. The postoperative course was without complications, and he was discharged 12 days after surgery. Follow-up observation without postoperative adjuvant chemotherapy was planned, according to the patient's wishes.
要旨
症例は65歳,男性。 S状結腸癌に対し腹腔鏡下S状結腸切除術を施行され,術後補助化学療法としてS-1内服を8コース施行された。術後3年3か月で肝転移および下腸間膜動脈(IMA)根部リンパ節腫大と両側水腎症を認めた。左水腎症の原因はIMA根部リンパ節転移の浸潤によるものと考えられた。腹腔鏡下肝S5部分切除術・IMA根部リンパ節切除術(左尿管合併切除)・両側尿管ステント留置・左尿管再建術を施行した。合併症なく経過し,術後12日目に退院となった。本人の希望で術後補助化学療法は行わず経過観察中である。