Fujita Shotaro, Momma Tomoyuki, Nakano Hiroshi, Yamauchi Naoto, Yamada Leo, Matsumoto Takuro, Kanke Yasuyuki, Hanayama Hiroyuki, Watanabe Yohei, Onozawa Hisashi, Okayama Hirokazu, Sakamoto Wataru, Saito Motonobu, Saze Zenichiro, Kono Koji
Dept. of Gastrointestinal Tract Surgery, Fukushima Medical University.
Gan To Kagaku Ryoho. 2020 Dec;47(13):1869-1871.
Surgical resection is the most effective treatment for liposarcoma, a retroperitoneal malignant soft tissue tumor, and a reliable negative margin is required because of the high risk of local recurrence. We reported a case of pelvic liposarcoma that could be resected by laparoscopic and transsacral hybrid approach. A 60's-man had a mixed liposarcoma occupying the right rear of the pelvis in the rectum. The operation was preceded by a laparoscopic operation, and the right internal iliac artery and vein and the superior rectal artery were dissected. The tumor was separated along the right pelvic wall. The oral rectum was transected and the colon was elevated by the extraperitoneal route. After conversion to the Jackknife position, the anterior sacrum was exfoliated with the right transsacral approach, the coccyx was resected, and the rectal anus, tumor, and surrounding fatty tissue were removed as an en bloc fasion. Histopathological examination showed mixed type of liposarcoma and negative margin of the stump. The patient is alive without recurrence 8 months after the surgery.
手术切除是治疗脂肪肉瘤（一种腹膜后恶性软组织肿瘤）最有效的方法，由于局部复发风险高，需要获得可靠的阴性切缘。我们报告了一例盆腔脂肪肉瘤病例，该病例可通过腹腔镜和经骶骨联合入路进行切除。一名60多岁男性患有混合性脂肪肉瘤，占据直肠周围盆腔右后部。手术先进行腹腔镜操作，解剖右侧髂内动静脉和直肠上动脉。肿瘤沿右侧盆腔壁分离。切断直肠上段，经腹膜外途径提起结肠。转为折刀位后，采用右侧经骶骨入路剥离骶骨前部，切除尾骨，将直肠肛门、肿瘤及周围脂肪组织整块切除。组织病理学检查显示为混合型脂肪肉瘤，切缘阴性。患者术后8个月存活，无复发。
