直腸癌と前立腺癌の重複癌に対し一期的腹腔鏡下手術を施行した1例

Laparoscopic surgery for synchronous prostate and rectal cancer : A case report

◆要旨：患者は60歳代，男性．便潜血陽性を主訴に近医を受診し，大腸内視鏡検査で直腸癌（Ra, cT1b, N0, M0, cStageⅠ）を認めた．また，PSA高値のため行った針生検では，前立腺癌（T2c, N0, M0, StageⅡ）も合併していた．低侵襲性を考慮し，根治術を同時に施行する方針となった．手術はまず，後腹膜アプローチで前立腺全摘および両側閉鎖リンパ節郭清を行った．その後，腹腔内アプローチで低位前方切除，D3リンパ節郭清を行い，回腸人工肛門を造設した．術後経過は良好であり，第11病日に退院となった．直腸癌，前立腺癌の同時性重複癌に対し，同時に腹腔鏡下手術を施行した報告は少ない．自験例は腹腔鏡下に手術を行うことで患者に負担が少なく，低侵襲に同時根治切除を施行することができた．

A man in his 60s had a positive fecal occult test and a high PSA value. Colonoscopy revealed a rectal cancer, and a prostatic needle biopsy confirmed prostate cancer. Simultaneous laparoscopic surgery for rectal and prostate cancers was performed. Firstly, retroperitoneal approach was applied to laparoscopic prostatectomy. Subsequently, laparoscopic assisted low anterior resection with diverting stoma construction was performed. The postoperative course was uneventful and the patient left the hospital on 11 postoperative day. There are few reports of laparoscopic surgery performed concurrently for rectal and prostate cancers. Simultaneous laparoscopic surgery for rectal and prostate cancers is considered feasible and useful in terms of less invasiveness and radical cure.