腹腔鏡下に一期的に切除した上行結腸癌と腎臓癌の1例

A case of ascending colon cancer and renal cell carcinoma successfully resected by laparoscopic surgery

近年，大腸癌ならびに腎臓癌に対して，内視鏡下手術が標準術式となりつつある．今回，筆者らは腹腔鏡下に一期的に切除しえた上行結腸癌，腎臓癌の1例を経験したので報告する．症例は63歳，男性．血便を主訴に近医より紹介された．大腸内視鏡検査で上行結腸に長径3cm大，1/3周を有するⅡ型腫瘍を認め，大腸癌と診断された．術前腹部CTで右腎臓に直径3cmの造影される腫瘍を認め，腹部超音波も合わせて腎臓癌が疑われた．腹腔鏡下に一期的に結腸右半切除術，右腎臓摘出術を施行した．術後10日目に退院した．手術時間の問題はあるが，重複癌に対しても腹腔鏡下手術は低侵襲，整容上の利点，診断的意義の観点からも有用であると考えられた．

　Recently, endoscopic surgery has become the standard surgical procedure for patient with colon cancer or renal cell carcinoma. We report a patient with ascending colon cancer and renal cell carcinoma that were successfully and simultaneously resected by laparoscopic surgery

　A 63-year-old man was referred to our hospital for examination of bloody stool. Colonoscopy revealed a 3 cm-lengthed typeⅡtumor, and about one-third the circumfernce which was diagnosed as ascending colon cancer. Abdominal CT revealed a 3 cm-lengthed enhanced tumor in the right kidney. The tumor was suspected to be a renal cell carcinoma by abdominal CT and US. Right hemicolectomy and right nephrectomy were performed laparoscopically. The patient was discharged home on the 10th postoperative day.

　Although laparoscopic surgery may require more operation time, it is a favorable treatment for double cancer because of less invasiveness, cosmetic advantage, and precise diagnosis.