Laparoscopy-assisted resection for a patient with ascending colon cancer and a malrotated kidney : A case report Akihiro MIKI 1 , Mina NAGAO 1 , Atsushi IKEDA 1 , Masao FUJIWARA 1 , Junji KOMORI 1 , Yasuhide ISHIKAWA 1 1Department of Gastroenterological Surgery, Takamatsu Red Cross Hospital Keyword: 腎回転異常 , 大腸癌 , 腹腔鏡 pp.372-376
Published Date 2020/9/15
DOI https://doi.org/10.11477/mf.4426200833
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 A 77-year-old man presented with anemia. A tumor in the ascending colon and right hilum of the kidney ventral of the bifurcation of the common iliac artery was identified on contrast-enhanced computed tomography (CT) and three-dimensional CT. Under a diagnosis of ascending colon cancer with a right malrotated kidney, laparoscopy-assisted D3 right hemicolon resection was performed. We first employed an approach using retroperitoneal peeling (i.e. retroperitoneal-approach) with an incision at the mesenteric root. Because the right hilum of the kidney was rotated ventrally and laterally (toward the ileocecal area), the risk of injuring the hilum was associated with the lateral incision of the mesenteric root. Therefore, the mesenteric root was incised from the medial cranial side (duodenal attachment). The malrotated kidney showed some anatomical anomalies, so careful consideration based on preoperative three-dimensional CT was necessary. In our case, the operation was able to be safely performed due to the landmark of a mesentery incision at the duodenal attachment.

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