Kim Hannah, Seo An Na, Park Soo Yeun
Department of Surgery, Kyungpook National University Hospital, Daegu, Korea.
Department of Pathology, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu, Korea.
Ann Coloproctol. 2023 Jun;39(3):283-286. doi: 10.3393/ac.2022.00780.0111. Epub 2023 Feb 9.
The aim of this video is to present the procedural details of laparoscopic right hemicolectomy with aortocaval (infrarenal aortic bifurcation) lymphadenectomy, partial resection of the pelvic peritoneum (peritoneal carcinomatosis index, 3), and hyperthermic intraperitoneal chemotherapy in a patient who received neoadjuvant chemotherapy for stage IVc colorectal cancer. The total operation time was 290 minutes, and the patient was discharged on a postoperative day 13 without any complications. No postoperative complications occurred until postoperative day 60. The pathological stage of the tumor was determined to be T3N2bM1c. The pelvic peritoneal nodule was pathologically confirmed as a metastatic lesion. Among the 12 harvested aortocaval lymph nodes, 6 were metastatic lymph nodes. The minimally invasive approach was safe and feasible in this highly selected patient with colon cancer, aortocaval lymph nodes, and peritoneal metastases.
本视频的目的是展示一名接受新辅助化疗的IVc期结直肠癌患者的腹腔镜右半结肠切除术、主动脉腔静脉(肾下主动脉分叉处)淋巴结清扫术、盆腔腹膜部分切除术(腹膜癌指数为3)以及腹腔内热化疗的手术操作细节。总手术时间为290分钟,患者术后第13天出院,无任何并发症。术后60天内未发生任何术后并发症。肿瘤的病理分期为T3N2bM1c。盆腔腹膜结节经病理证实为转移灶。在切除的12枚主动脉腔静脉淋巴结中,有6枚为转移淋巴结。对于这名经过严格筛选的患有结肠癌、主动脉腔静脉淋巴结转移及腹膜转移的患者,微创方法是安全可行的。