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[腹腔镜辅助下右半结肠切除术治疗阑尾黏液腺癌1例]

[A Case of Laparoscopy Assisted Ileocecal Resection for Large Appendiceal Mucinous Adenocarcinoma].

作者信息

Hashimoto Masahiro, Murata Kohei, Kagawa Yoshinori, Naito Atsushi, Kawai Kenji, Sakamoto Takuya, Murakami Kohei, Katsura Yoshiteru, Omura Akihisa, Masuzawa Toru, Takeno Atsushi, Yoshimura Michiko, Takeda Yutaka, Kato Takeshi, Tamura Shigeyuki

机构信息

Dept. of Surgery, Kansai Rosai Hospital.

出版信息

Gan To Kagaku Ryoho. 2018 Feb;45(2):384-386.

Abstract

Appendiceal mucinous adenocarcinoma accompanied by cysts ruptures by surgical operation and leakage of mucus into the peritoneal cavity results in deterioration of prognosis.We report a case where the appendix mucinous adenocarcinoma was safely excised by laparoscopically preceding vascular treatment, lymph node dissection and intestinal dissection.The case was a woman in her forty-age suffering from the right lower quadrant and fever; no improvement was observed even when antibiotics were administered.A cystic lesion with a maximum diameter of 75mm was found on the right side of the pelvis with CT, and numerous lymph adenopathy was observed along the iliac artery.Preoperative diagnosis was diagnosed as appendiceal mucinous adenocarcinoma suspected and laparoscopic resection of the cecum was performed with the above procedure without breaking the cyst.Pathological diagnosis was findings of appendicular mucinous adenocarcinoma.She was discharged on the 7th postoperative day after surgery, 6 months after surgery without relapse survival.In order to resect a cystic tumor by laparoscopic surgery, it is considered to be useful to take care to prevent the forceps from touching the tumor, and perform a procedure that precedes vascular dissection and intestinal dissection.

摘要

阑尾黏液腺癌伴囊肿因手术导致囊肿破裂,黏液漏入腹腔会使预后恶化。我们报告一例通过腹腔镜手术先行血管处理、淋巴结清扫和肠段切除,成功安全切除阑尾黏液腺癌的病例。该病例为一名四十多岁的女性,患有右下腹疼痛和发热;即使使用抗生素治疗也未见好转。CT检查发现盆腔右侧有一个最大直径为75mm的囊性病变,沿髂动脉观察到多处淋巴结肿大。术前诊断怀疑为阑尾黏液腺癌,遂按上述步骤进行腹腔镜下盲肠切除术,术中未弄破囊肿。病理诊断为阑尾黏液腺癌。术后第7天出院,术后6个月无复发存活。为通过腹腔镜手术切除囊性肿瘤,注意防止钳子触碰肿瘤,并先行血管解剖和肠段解剖的操作被认为是有用的。

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