腹腔鏡下仙骨腟固定術後に腹腔鏡下高位前方切除を施行したRS直腸癌の1例

A case of rectal adenocarcinoma after laparoscopic sacropolpopexy treated with laparoscopic high anterior resection

◆要旨：症例は65歳の女性．下血を主訴に受診し，下部消化管内視鏡検査でRS直腸に2型進行癌を認め，腹腔鏡下高位前方切除術を施行した．4か月前に当院泌尿器科で，子宮脱に対して腹腔鏡下仙骨腟固定術（laparoscopic sacrocolpopexy：以下，LSC）を施行していた．近年，骨盤臓器脱手術であるLSCが徐々に普及しつつあり，当院でも2016年より施行している．一般的に骨盤内手術後の直腸癌手術は，癒着や解剖の変化に伴い難易度が高くなると報告されている．LSC後のRS直腸癌に対して腹腔鏡下高位前方切除術を施行した報告はこれまでになく，記録すべき症例として報告する．

　A 65-year-old female referred to our hospital with complaint of melena. Colonoscopy revealed an advanced type 2 carcinoma in the upper rectum, and laparoscopic high anterior resection was performed. Laparoscopic sacrocolpopexy（LSC）was performed in our institution four months ago. In recent years, LSC is gradually becoming widespread for pelvic organ prolapse, and it has been adopted at our institution since 2016 years. In general, it has been reported that rectal surgery after pelvic surgery becomes more difficult due to adhesions and anatomical changes. There has never been a report of laparoscopic high anterior resection for rectal cancer after LSC, and we report it as a case to be recorded.