腹腔鏡下に同時切除しえた上行結腸癌に併発した腸間膜リンパ管腫の1例

A case of lymphangioma with ascending colon cancer simultaneously resected by laparoscopic surgery

◆要旨：患者は79歳，男性．便潜血陽性で施行した下部消化管内視鏡検査で上行結腸癌と診断し，また遠隔転移検索目的に施行した胸腹部CTで，空腸腸間膜内と考えられる部位に長径12cmの囊胞性腫瘤を認め，腸間膜リンパ管腫と診断した．これらに対して腹腔鏡下右半結腸切除術および腫瘍摘出術を施行した．手術は5ポートで行い，まず腸間膜リンパ管腫を摘出し，その後D3郭清を伴う右半結腸切除術を施行した．術中・術後に明らかな合併症は認めなかった．病理組織学的に囊胞性腫瘤はリンパ管腫と診断した．これまで本邦で大腸癌手術と同時に腸間膜リンパ管腫を腹腔鏡下手術で切除した報告はなく，今回筆者らが経験した症例を報告する．

A 79-year-old man was referred due to fecal occult blood. He underwent colonoscopy and was diagnosed with ascending colon cancer. In the Computed tomography seeking for metastasis, a 12cm cystic tumor was detected in the jejunal mesentery. The cyst was clinically diagnosed as mesenteric lymphangioma. He underwent a laparoscopic surgery of right hemicolectomy and resection of lymphangioma simultaneously. The operation was done by 5 ports. Firstly, mesenteric lymphangioma was resected, and secondly right hemicolectomy with D3 lymph node dissection was performed. There were no intra- or postoperative complications. The cystic tumor was pathologically diagnosed as lymphangioma. This is the first report of a case of lymphangioma resected by laparoscopic surgery simultaneously with colorectal cancer.