Takashima Junpei, Kobayashi Hirotoshi, Suzuki Yuta, Koizumi Ayaka, Shigehara Fumi, Yamasaki Kenji, Fujimoto Daisuke, Sugimoto Hitoshi, Miura Fumihiko, Taniguchi Keizo, Matsutani Noriyuki, Takahashi Mikiko
Dept. of Surgery, Teikyo University School of Medicine Mizonokuchi Hospital.
Gan To Kagaku Ryoho. 2022 Dec;49(13):1550-1552.
We report a case of laparoscopic sigmoidectomy for sigmoid colon cancer where a laparotomy transition prevented peritoneal metastasis from being missed. Case: A 64-year-old woman was diagnosed with sigmoid colon cancer. Computed tomography revealed a large bowel obstruction and a 12 mm wide basal bulge in the gallbladder. A laparoscopic sigmoidectomy( D3 dissection)was first performed, and intra-abdominal observation revealed no disseminated nodules. A laparoscopic cholecystectomy was performed continuously but, due to strong adhesions, a laparotomy was administered. Three disseminated nodules were observed in the omentum during the laparotomy and a postoperative pathological examination revealed pT4aN1b(2/23)M1c1(P2), pStage Ⅳc. Adjuvant chemotherapy of 8 courses of CAPOX was performed and there has been no recurrence 20 months after surgery.
我们报告一例因乙状结肠癌行腹腔镜乙状结肠切除术的病例，术中开腹转变操作避免了遗漏腹膜转移灶。病例：一名64岁女性被诊断为乙状结肠癌。计算机断层扫描显示大肠梗阻，胆囊有一个12毫米宽的基底隆起。首先进行了腹腔镜乙状结肠切除术（D3清扫），腹腔内观察未发现播散性结节。随后连续进行腹腔镜胆囊切除术，但由于粘连严重，改为开腹手术。开腹手术中在大网膜发现3个播散性结节，术后病理检查显示为pT4aN1b(2/23)M1c1(P2)，p分期Ⅳc期。术后进行了8个疗程的CAPOX辅助化疗，术后20个月无复发。
