腹腔鏡下に胃全摘術と回盲部切除術を一期的に施行した胃・上行結腸重複癌の1例

Combined laparoscopic total gastrectomy and ileocecal resection for synchronous gastric and colon cancer

◆要旨：患者は78歳の女性．体重減少を主訴に近医を受診し，胃癌の診断で当科を紹介され受診した．胃体上部後壁に0-IIa+IIc型病変を認め，術前スクリーニングとして施行した下部消化管内視鏡検査でBauhin弁近傍の上行結腸にIs型病変も指摘された．画像診断で遠隔転移は認められなかった．胃癌・上行結腸癌の重複癌と診断し，一期的に腹腔鏡下で胃全摘術と回盲部切除術を施行した．胃と大腸をそれぞれ専門手術チームが担当することにより，安全にストレスなく手術を施行でき，手術時間は5時間59分，出血量は20mlであった．また術後合併症も認めなかった．

　A 78-year-old female was referred to our hospital with gastric cancer. The upper gastrointestinal endoscopy revealed 0-Ⅱa+Ⅱc lesion in the upper body of the stomach. The patient underwent screening colonoscopy and demonstrated a Ⅰs lesion in the ascending colon. We simultaneously performed laparoscopic total gastrectomy and ileocecal resection for synchronous gastric and colon cancer. The operation was performed by each different professional team for gastric and colon cancer. Total operative time was 359 minutes and the estimated blood loss was 20ml. Surgery was safe and smooth and there were no remarkable complications due to the collaboration.