内容紹介
Summary
An 83-year-old woman was referred to our hospital for cecal cancer, and ileocecal resection(D3 lymph node resection)with functional end-to-end anastomosis. Since the tumor was of histological StageⅠ, no adjuvant chemotherapy was performed. One year and 9 months after the operation, an anastomotic recurrence was identified along the staple line using colonoscopy. We performed a resection of the anastomotic recurrence. At present, 6 months after the second operation, the patient remains in good health without evidence of recurrence. A few cases of anastomotic recurrence after surgery for StageⅠ colon cancer have been reported in the literature available in Japanese. We report a rare case of an anastomotic recurrence of StageⅠ cancer after functional end-to-end anastomosis.
要旨
症例は83歳,女性。盲腸癌に対して開腹下回盲部切除+D3郭清を施行した。吻合は自動縫合器を使用し,機能的端々吻合(functional end-to-end anastomosis: FEEA)を行った。病理組織学的診断はtype 1,7×5 cm,pMP,pN0,pPM0,pDM0,StageⅠであった。術後1年9か月目の定期検査で貧血を指摘され,精査の大腸内視鏡検査にて吻合部上に半周性の2型腫瘍を認め,吻合部再発の診断で手術となった。前回吻合部を中心に結腸側,回腸側ともに10 cmずつ切除し,吻合はFEEAで行った。今回,比較的まれであるFEEA施行後に吻合部再発を来したStageⅠ盲腸癌の1例を経験したので報告する。implantationによる再発予防,術後の定期的なフォローアップなどが重要であると思われた。
目次
An 83-year-old woman was referred to our hospital for cecal cancer, and ileocecal resection(D3 lymph node resection)with functional end-to-end anastomosis. Since the tumor was of histological StageⅠ, no adjuvant chemotherapy was performed. One year and 9 months after the operation, an anastomotic recurrence was identified along the staple line using colonoscopy. We performed a resection of the anastomotic recurrence. At present, 6 months after the second operation, the patient remains in good health without evidence of recurrence. A few cases of anastomotic recurrence after surgery for StageⅠ colon cancer have been reported in the literature available in Japanese. We report a rare case of an anastomotic recurrence of StageⅠ cancer after functional end-to-end anastomosis.
要旨
症例は83歳,女性。盲腸癌に対して開腹下回盲部切除+D3郭清を施行した。吻合は自動縫合器を使用し,機能的端々吻合(functional end-to-end anastomosis: FEEA)を行った。病理組織学的診断はtype 1,7×5 cm,pMP,pN0,pPM0,pDM0,StageⅠであった。術後1年9か月目の定期検査で貧血を指摘され,精査の大腸内視鏡検査にて吻合部上に半周性の2型腫瘍を認め,吻合部再発の診断で手術となった。前回吻合部を中心に結腸側,回腸側ともに10 cmずつ切除し,吻合はFEEAで行った。今回,比較的まれであるFEEA施行後に吻合部再発を来したStageⅠ盲腸癌の1例を経験したので報告する。implantationによる再発予防,術後の定期的なフォローアップなどが重要であると思われた。