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◆要旨:患者は52歳,男性.胆囊結石に対する腹腔鏡下胆囊摘出術の既往があった.腹部症状は認めないが血尿の精査で施行された腹部CT検査で偶然に骨盤内腫瘍が発見され,諸検査後に摘出手術を施行した.経仙骨的と経腹的の二方向からアプローチして下部直腸とともに腫瘍を摘出したが,経腹的操作は腹腔鏡下に遂行した.腹腔鏡下に腫瘍の全貌を認識することは困難であったが,骨盤内操作は良視野で遂行可能であった.また,煩雑であったものの二方向からのアプローチは腫瘍を一塊として摘出するために有用であった.摘出腫瘍は孤立性線維性腫瘍と最終診断したが,腫瘍と直腸との連続性は認められず,直腸間膜内に発生したものと考えられた.
The patient was a 52-year-old male with a past history of laparoscopic cholecystectomy for cholecystolithiasis. He complained of hematuria and abdominal CT was performed for further examination. The CT showed a round mass in the pelvic cavity. Operation was performed by both trans-abdominal and trans-sacral route approach. The trans-abdominal approach was performed under laparoscopic method. Although we could not grasp the full view of the tumor, we were able to abrade around the rectum with a comparatively good view under laparoscope. We removed the tumor with lower rectum as a mass. The two route approach was complicated but was effective for the excision of the tumor as a mass. Histological examination showed the tumor to be solitary fibrous tumor arising from the mesenterium of the rectum.
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