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Japanese

Laparoscopic restorative proctocolectomy and simultaneous resection of synchronous liver metastases for familial adenomatous polyposis with stage Ⅳ transverse colon cancer Takashi UEKI 1 , Tatsuya MANABE 1 , Kinuko NAGAYOSHI 1 , Ryo MAEYAMA 1 , Masao TANAKA 1 1Department of Surgery and Oncology, Graduate School of Medical Science, Kyushu University Keyword: 腹腔鏡下大腸全摘 , 癌併発家族性大腸腺腫症 , 同時肝切除 pp.77-82
Published Date 2015/1/15
DOI https://doi.org/10.11477/mf.4426200064
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 We present our experience of simultaneous laparoscopic surgery for an 18-year-old female patient affected by familial adenomatous polyposis with advanced transverse colon cancer, multiple lymph node involvement and two liver metastases. Colonoscopy demonstrated an ulcerating tumor at transverse colon and numerous polyps in colon and rectum. CT scan and MR revealed multiple lymph node swellings in the transverse mesocolon and two small nodules in the medial segment of the liver. Total proctocolectomy, D3 lymph node dissection and liver resection were performed under laparoscopy. A 13-cm ileal J pouch was constructed extracorporeally and the pouch anal anastomosis was performed transanally. Diverting ileostomy was not conducted. The operating time was 671 minutes. Blood loss was 50ml and the postoperative hospital stay was 26 days without any complication. Laparoscopic surgery is feasible for this complex clinical setting and a restorative proctocolectomy without diverting ileostomy may eventually bring a good cosmetic outcome.


Copyright © 2015, JAPAN SOCIETY FOR ENDOSCOPIC SURGERY All rights reserved.

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

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