Complete laparoscopic colectomy with intracorporeal anastomosis for colon cancer with intestinal malrotation Shotaro TAKI 1 , Fumihiko FUJITA 2 , Suguru FUKAHORI 1 , Takafumi OCHI 2 , Tomoaki MIZOBE 2 , Yoshito AKAGI 2 1Department of Pediatric Surgery, Kurume University School of Medicine 2Department of Surgery, Kurume University School of Medicine Keyword: 腹腔鏡下手術 , 腸回転異常 , 大腸癌 pp.39-44
Published Date 2021/1/15
DOI https://doi.org/10.11477/mf.4426200870
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 We report a rare case of a male in his sixties presenting with aortic regurgitation, and showing positive fecal blood reaction. Colonoscopy showed a suspected small tumor in the ascending colon. Contrast CT showed that most of the small intestine was located on the right side in the abdomen, and the superior mesenteric vein was located on the left side of the superior mesenteric artery - the SMV rotation sign - indicating intestinal malrotation. We performed laparoscopic surgery to cut the ileocolic vein and artery in order to dissect the lymph nodes. The ascending colon and transverse colon were adhered strongly to the retroperitoneum, making extracorporeal anastomosis difficult. Therefore, we performed intracorporeal anastomosis after intestinal resection. The postoperative course was uneventful, and the patient was discharged at 14 days after surgery. In cases of colon cancer with intestinal malrotation, it is important to understand the anatomy especially the direction of flow in the mesenteric vasculature, prior to surgery. In the present case, intracorporeal anastomosis could be performed successfully and did not require wide remobilization of the intestine which was adhered to the peritoneum.

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