Takahashi Rina, Sakamoto Kazuhiro, Tomiki Yuichi, Kojima Yutaka, Takahashi Makoto, Sugimoto Kiichi, Kawai Masaya, Okazawa Yu, Makino Yurika
Department of Coloproctological Surgery, Juntendo University Faculty of Medicine, Tokyo, Japan.
Asian J Endosc Surg. 2016 Nov;9(4):300-302. doi: 10.1111/ases.12293. Epub 2016 Jul 26.
A 75-year-old man tested positive for occult blood in the stool. A subsequent examination indicated concurrent locally advanced cancer (cT3) at the hepatic flexure and lower rectum cancer in the external anal sphincter. Because of the locally advanced rectal cancer (cT4), preoperative chemoradiotherapy was administered. First, laparoscopic right hemicolectomy and colostomy were performed at the sigmoid colon. Chemoradiotherapy for rectal cancer was initiated on day 18 after the surgeries. Seven weeks after chemoradiotherapy had been completed, laparoscopic abdominoperineal resection and right lateral pelvic lymph node dissection were performed. This case demonstrated that a second radical surgery for rectal cancer could be performed safely and laparoscopically after laparoscopic colectomy and colostomy.
一名75岁男性粪便潜血检测呈阳性。随后的检查显示，肝曲处同时存在局部进展期癌（cT3）以及肛门外括约肌处的低位直肠癌。由于局部进展期直肠癌（cT4），患者接受了术前放化疗。首先，在乙状结肠进行了腹腔镜右半结肠切除术和结肠造口术。术后第18天开始进行直肠癌的放化疗。放化疗完成7周后，进行了腹腔镜腹会阴联合切除术和右侧盆腔淋巴结清扫术。该病例表明，在腹腔镜结肠切除术和结肠造口术后，可以安全地通过腹腔镜进行直肠癌的二期根治性手术。
