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Japanese

A case of sigmoid colon cancer that was difficult to treat by laparoscopic resection and anastomosis due to the complications of IgG4-related retroperitoneal fibrosis for which definite diagnosis was made by laparoscopic biopsy Takeshi KAIDA 1,2 , Atsushi IKEDA 1 , Nozomi IWAMA 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: 腹腔鏡下生検 , IgG4関連後腹膜線維症 , S状結腸癌 pp.527-534
Published Date 2015/9/15
DOI https://doi.org/10.11477/mf.4426200174
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The patient was a 64-year-old woman in whom sigmoid colon cancer was found using lower gastrointestinal endoscopy. Contrast-enhanced CT revealed marked retroperitoneum thickening near the ventral aorta and hydronephrosis of the left kidney. Her serum IgG4 concentration was elevated. The preoperative diagnosis was sigmoid colon cancer with concurrent IgG4-related retroperitoneal fibrosis. A ureteral stent was placed, followed by laparoscopic retroperitoneal biopsy and sigmoid colectomy. Rapid pathological examination of the retroperitoneal tissue revealed no malignant findings. Difficulties were encountered during dissection and mobilization of the mesentery and blood vessel treatment in sigmoid colectomy. Transanal intestinal anastomosis was also difficult; therefore, a small laparotomy was performed. Preoperative evaluation of the biopsy site and the biopsy technique are crucial to safely perform retroperitoneal biopsy. Furthermore, when performing sigmoid colectomy on cases with the complication of retroperitoneal fibrosis, due care should be taken during dissection and mobilization of the mesentery and anastomosis.


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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