内容紹介
Summary
A 67-year-old woman presented with bloody stools to a local physician. Lower gastrointestinal endoscopy revealed a type 3 all-circumferential tumor at descending colon. She was diagnosed with descending colon cancer and referred to our hospital for surgery. Preoperative computed tomography(CT)revealed a horseshoe kidney. We performed single-incision laparoscopic colectomy for descending colon cancer(cT3cN0cM0, cStageⅡa)complicated by a horseshoe kidney. The surgery was performed safely without any additional injuries. In patients with horseshoe kidneys, abnormalities have been reported in the running of the blood vascular system and the renal pelvis and ureter systems. Thus, sufficient understanding of the anatomic abnormality by preoperative examinations, such as 3D-CT, is essential for performing surgery safely.
要旨
症例は67歳,女性。血便を主訴に近医を受診し,下部消化管内視鏡検査にて下行結腸に全周性の3型腫瘍を認め,下行結腸癌と診断され手術目的に当科紹介となった。術前のCTで馬蹄腎を認めた。馬蹄腎を併存した下行結腸癌(cT3cN0cM0,cStageⅡa)に対し,単孔式腹腔鏡下下行結腸切除術を施行した。術中,副損傷などはなく安全に手術は終了した。馬蹄腎は症例により血管系・腎盂尿管系の走行に異常を認めるため,3D-CTなどの術前検査で十分に解剖学的異常の把握を行うことが安全に手術を行う上で肝要であると考えられた。
目次
A 67-year-old woman presented with bloody stools to a local physician. Lower gastrointestinal endoscopy revealed a type 3 all-circumferential tumor at descending colon. She was diagnosed with descending colon cancer and referred to our hospital for surgery. Preoperative computed tomography(CT)revealed a horseshoe kidney. We performed single-incision laparoscopic colectomy for descending colon cancer(cT3cN0cM0, cStageⅡa)complicated by a horseshoe kidney. The surgery was performed safely without any additional injuries. In patients with horseshoe kidneys, abnormalities have been reported in the running of the blood vascular system and the renal pelvis and ureter systems. Thus, sufficient understanding of the anatomic abnormality by preoperative examinations, such as 3D-CT, is essential for performing surgery safely.
要旨
症例は67歳,女性。血便を主訴に近医を受診し,下部消化管内視鏡検査にて下行結腸に全周性の3型腫瘍を認め,下行結腸癌と診断され手術目的に当科紹介となった。術前のCTで馬蹄腎を認めた。馬蹄腎を併存した下行結腸癌(cT3cN0cM0,cStageⅡa)に対し,単孔式腹腔鏡下下行結腸切除術を施行した。術中,副損傷などはなく安全に手術は終了した。馬蹄腎は症例により血管系・腎盂尿管系の走行に異常を認めるため,3D-CTなどの術前検査で十分に解剖学的異常の把握を行うことが安全に手術を行う上で肝要であると考えられた。