右腎細胞癌と上行結腸癌の同時性重複癌に対して腹腔鏡補助下根治的腎摘除術兼右結腸切除術を施行した1例

Simultaneous laparoscopic radical nephrectomy and laparoscope-assisted right colectomy for synchronous renal cell carcinoma and colonic adenocarcinoma

◆要旨：近年，腎細胞癌や大腸癌において腹腔鏡下手術はそれぞれ標準術式として確立されつつあるが，両者の同時性重複癌に対する腹腔鏡下切除例の報告は稀である．今回，筆者らは右腎細胞癌と上行結腸癌の同時性重複例に対して腹腔鏡下手術を施行し，良好な経過を得たので報告する．患者は53歳，女性．上行結腸のlaterally spreading tumorと右腎癌の診断で腹腔鏡下根治的右腎摘除術兼右結腸切除術を施行した．筆者らの検索しえた限りでは，大腸癌と腎細胞癌の腹腔鏡下同時切除報告例は3例のみで，いずれも海外の報告である．自験例は右腎細胞癌と上行結腸癌の重複例に対し，腹腔鏡下同時切除を施行した本邦報告第1例目である．

　Although laparoscopic approach is becoming accepted as the treatment for localized renal cell carcinoma or locally advanced colorectal carcinoma, simultaneous laparoscopic resection for the synchronous cancer in the kidney and colon is rarely reported. We present a patient with early carcinoma of the ascending colon and renal cell carcinoma of the right kidney. A 53-year-old-woman came to our institute with the abnormality of her fecal occult blood. Colonoscopy revealed a laterally spreading tumor of the ascending colon. CT scan showed a mass measuring 2 cm in diameter in the right kidney. Synchronous laparoscopic resection of the two carcinomas was performed successfully. To the best of our knowledge, there are three overseas reported cases of simultaneous laparoscopic resection for the synchronous cancer in the kidney and colon. This is the first patient who underwent simultaneous laparoscopic resection for the synchronous cancer in the kidney and colon in Japan.