Okamoto Kazuaki, Emoto Shigenobu, Sasaki Kazuhito, Nozawa Hiroaki, Kawai Kazushige, Murono Koji, Iida Yuuki, Ishii Hiroaki, Yokoyama Yuichiro, Anzai Hiroyuki, Sonoda Hirofumi, Ishihara Soichiro
Department of Surgical Oncology, The University of Tokyo, Tokyo, Japan.
J Anus Rectum Colon. 2021 Apr 28;5(2):202-206. doi: 10.23922/jarc.2020-097. eCollection 2021.
The Deloyers procedure is performed after extended left colectomy, enabling the reach of the proximal colon to the rectum for anastomosis while preserving sufficient blood supply. We report a case of the Deloyers procedure performed safely under indocyanine green (ICG) fluorescence guidance. A 50-year-old man with obesity (body mass index, 35.7 kg/m) and a history of diabetes underwent an extended left hemicolectomy and ultralow anterior resection of the rectum as radical resection for transverse and sigmoid colon cancers and a lower rectal neuroendocrine tumor. Reconstruction was performed by the Deloyers procedure. A necessary length of the transverse colon with reduced blood flow was additionally resected under ICG fluorescence guidance, and a transanal hand-sewn coloanal anastomosis was performed. This is the first report in which the Deloyers procedure was performed successfully with the ICG fluorescence method. ICG fluorescence may be useful when combined with the Deloyers procedure.
德洛耶斯手术在扩大左半结肠切除术后进行，可使近端结肠抵达直肠以进行吻合，同时保留充足的血供。我们报告了一例在吲哚菁绿（ICG）荧光引导下安全实施德洛耶斯手术的病例。一名50岁肥胖男性（体重指数，35.7 kg/m），有糖尿病史，因横结肠癌和乙状结肠癌以及低位直肠神经内分泌肿瘤接受了扩大左半结肠切除术和直肠超低位前切除术作为根治性切除。通过德洛耶斯手术进行重建。在ICG荧光引导下额外切除了一段血流减少的横结肠必要长度，并进行了经肛门手工缝合结肠肛管吻合术。这是首次成功使用ICG荧光法实施德洛耶斯手术的报告。ICG荧光与德洛耶斯手术联合使用时可能有用。
