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[1例早期直肠癌经内镜黏膜下剥离术治疗9个月后复发并肝转移的病例]

[A Case of Early Rectal Cancer Recurring as Liver Metastasis Nine Months after ESD].

作者信息

Shigoka Masatoshi, Koganezawa Itsuki, Yokozuka Kei, Miyoshi Kenta, Tomita Koichi, Tabuchi Satoru, Chiba Naokazu, Katayanagi Sou, Nagakawa Yuichi, Katsumata Kenji, Tsuchida Akihiko, Kawachi Shigeyuki

机构信息

Dept. of Digestive and Transplantation Surgery, Tokyo Medical University Hachioji Medical Center.

出版信息

Gan To Kagaku Ryoho. 2019 Dec;46(13):2285-2287.

Abstract

A 70-year-oldwoman underwent colonoscopy as a follow-up examination for colon polyps, during which early-stage rectosigmoid cancer was detected. Endoscopic submucosal dissection(ESD)was performed to remove this lesion. Additional radical anterior resection was recommended according to the histological findings but the patient chose to undergo observation. Nine months after the ESD, the patient decided to undergo additional surgical resection: a CT scan revealed liver metastasis in S6. Laparoscopic anterior resection andpartial resection of S6 of the liver was performed. Histological analysis showed no residual cancer in the rectosigmoid, no lymph node metastasis, and liver metastasis in S6. Carcinoma cells were exposed on the radial margin of the liver. After surgery, oral UFT/LV chemotherapy was administered for 6 months. The patient remains free of recurrence 4 years and6 months after the surgery.

摘要

一名70岁女性因结肠息肉进行结肠镜随访检查,期间发现早期直肠乙状结肠癌。遂行内镜下黏膜剥离术(ESD)切除该病变。根据组织学检查结果建议追加根治性前切除术,但患者选择观察。ESD术后9个月,患者决定接受追加手术切除:CT扫描显示肝S6转移。遂行腹腔镜前切除术及肝S6部分切除术。组织学分析显示,直肠乙状结肠无残留癌,无淋巴结转移,肝S6转移。癌细胞暴露于肝脏的切缘。术后给予口服优福定/亚叶酸钙化疗6个月。术后4年6个月,患者仍无复发。

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