Nakajima Tomohiro, Iba Yutaka, Ishii Masayuki, Toyota Maho, Okuya Koichi
Department of Cardiovascular Surgery, Sapporo Medical University, Sapporo, JPN.
Department of Surgery, Division of Gastroenterological Surgery, Sapporo Medical University, Sapporo, JPN.
Cureus. 2025 May 27;17(5):e84916. doi: 10.7759/cureus.84916. eCollection 2025 May.
This report describes the case of a 69-year-old female patient. At the age of 68, she was diagnosed with cecum cancer, and infiltration of the right external iliac artery was detected. Owing to arterial infiltration, surgical resection was considered inappropriate, and a future risk of intestinal obstruction in the cecum region was anticipated. Therefore, a laparoscopic ileum-transverse colon bypass was performed. Subsequently, chemotherapy with the FOLFOXIRI (folinic acid, fluorouracil, oxaliplatin and irinotecan) regimen plus bevacizumab was administered for five months. Contrast-enhanced computed tomography revealed reduced infiltration of the right external iliac artery, prompting plans for ileocecal resection with combined resection of the right external iliac artery and iliopsoas muscle. After resection of the intestine, preserving the bypass site and tissue mobilization except the right external iliac artery infiltration site, systemic heparinization was performed. An 8 mm artificial vessel was then interposed to reconstruct the right external iliac artery using an end-to-end anastomosis technique. Lower extremity blood flow was unremarkable, and the postoperative course was uneventful. The patient was discharged on postoperative day 10 without complications.
本报告描述了一名69岁女性患者的病例。68岁时，她被诊断为盲肠癌，并检测到右髂外动脉受侵。由于动脉受侵，手术切除被认为不合适，预计盲肠区域未来有肠梗阻风险。因此，进行了腹腔镜回肠-横结肠旁路手术。随后，采用FOLFOXIRI（亚叶酸、氟尿嘧啶、奥沙利铂和伊立替康）方案联合贝伐单抗进行了五个月的化疗。增强计算机断层扫描显示右髂外动脉受侵减轻，促使计划进行回盲部切除并联合切除右髂外动脉和髂腰肌。切除肠道后，保留旁路部位并除右髂外动脉受侵部位外进行组织游离，然后进行全身肝素化。接着使用8毫米人工血管，采用端端吻合技术重建右髂外动脉。下肢血流无异常，术后过程顺利。患者术后第10天出院，无并发症。
