Utility of 3-D radiological vascular simulation of laparoscopic colectomy for advanced cecal cancer in a patient with intestinal malrotation : A case report and literature review Daishi NAOI 1 , Koji KOINUMA 1 , Gaku OTA 1 , Ken-ichi OSHIRO 1 , Hisanaga HORIE 1 , Naohiro SATA 1 1Department of Surgery, Division of Gastroenterological, General and Transplant Surgery, Jichi Medical University Keyword: 腹腔鏡手術 , 腸回転異常 , 大腸癌 pp.304-310
Published Date 2021/7/15
DOI https://doi.org/10.11477/mf.4426200920
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 A 79-year-old male presenting with melena was diagnosed with cecal cancer by double-balloon colonoscopy. He was not able to have a whole colon examination due to insertion difficulty during conventional colonoscopy one year ago. His body mass index was 33.7. Abdominal computed tomography showed that the entire small intestine was located at the right side of the abdomen, and the colon was at the left side. SMV rotation sign was also observed, indicating a diagnosis of intestinal malrotation. Laparoscopic ileocecal resection was performed. During the procedure, 3-D virtual angiography helped us to perform lymph node dissection and vessel ligation accurately and safely. Post-operative course was uneventful and he was discharged from our hospital 8 days after the surgery. Recently, laparoscopic treatments for colon cancer in patients with intestinal malrotation have been reported. However, this procedure is considered to be highly difficult due to anatomical characteristics. Preoperative 3D-CT angiography may be helpful to overcome such difficulties.

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