雑誌文献を検索します。書籍を検索する際には「書籍検索」を選択してください。

検索

書誌情報 詳細検索 by 医中誌

Japanese

Successful treatment of laparoscopic sigmoidectomy and D3 lymphadenectomy associated with horseshoe kidney : a case report Toshimichi TANAKA 1,2 , Atsushi IKEDA 1 , Hiroyuki SAKO 1 , Ken IKEDA 1 , Seijiro OKUSAWA 1 , Masahiko WATANABE 2 1Department of Surgery, Sano Kousei General Hospital 2Department of Surgery, Kitasato University School of Medicine Keyword: 馬蹄腎 , S状結腸癌 , 腹腔鏡 pp.601-608
Published Date 2013/9/15
DOI https://doi.org/10.11477/mf.4426100995
  • Abstract
  • Look Inside
  • Reference

We report a case of laparoscopic resection of sigmoid colon cancer associated with horseshoe kidney. A 73-year-old male referred for sigmoid colon cancer detected by colonoscopy was recognized by abdominal computed tomography to have a horseshoe kidney. The running of blood vessels and urinary duct were evaluated by three-dimensional CT angiography (3D-CTA) and intravenous pyelography. After preoperative examinations, laparoscopic sigmoidectomy and D3 lymphadenectomy were performed. Since the horseshoe kidney was displaced by postural change, we returned the patient to the horizontal position at the main lymphadenectomy. But, the root of inferior mesenteric artery remained unclear, because it was sandwiched between the duodenum and the horseshoe kidney isthmus. It was determined that treating it laparoscopically would be difficult. Therefore, a main lymphadenectomy and a blood vessel dissection were performed under direct vision from a small laparotomy wound. Moreover, superior hypogastric plexus ran in front of the horseshoe kidney isthmus. Hence, it was necessary to pay attention to the autonomic nerve preservation. If we fully understand the anatomical position relationship and devise a plan, such as postural change, small laparotomy and so on, laparoscopic surgery can be performed safely even in a colectomy associated with horseshoe kidney.


Copyright © 2013, JAPAN SOCIETY FOR ENDOSCOPIC SURGERY All rights reserved.

基本情報

電子版ISSN 2186-6643 印刷版ISSN 1344-6703 日本内視鏡外科学会

関連文献

もっと見る

文献を共有