Two Cases of Laparoscopic Sigmoidectomy for Sigmoid Colon Cancer with Extraction through the Orifice of an External Inguinal Hernia

Abstract Left-sided inferior vena cava (IVC) is a rare congenital malformation, as is persistent descending mesocolon, a developmental anomaly in which the colonic mesentery does not fuse with the dorsal abdominal wall. Although these anomalies are mostly asymptomatic, they should be identified preoperatively to avoid iatrogenic injury. We report a case of sigmoid colon cancer in a patient with both anomalies. The patient was an 80-year-old man whose preoperative computed tomography (CT) scan showed that the IVC ascended vertically along the left side of the abdominal aorta, and the descending colon was at the abdominal midline. Coronal CT was particularly useful for visualizing these anomalies. With this better understanding of the malpositioned anatomy, we successfully performed laparoscopic sigmoidectomy with lymph node dissection. Careful evaluation of preoperative CT imaging based on a clear understanding of such anatomical anomalies is particularly important for performing safe laparoscopic surgery.

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A case of total laparoscopic sigmoidectomy involving the use of needle forceps and transanal specimen extraction for sigmoid colon cancer

Journal of Minimal Access Surgery ◽

10.4103/jmas.jmas_110_17 ◽

2018 ◽

Vol 14 (1) ◽

pp. 71 ◽

Cited By ~ 1

Author(s):

Rina Takahashi ◽

Kazuhiro Sakamoto ◽

Hisashi Ro ◽

Kazumasa Kure ◽

Masaya Kawai ◽

...

Keyword(s):

Colon Cancer ◽

Sigmoid Colon ◽

Sigmoid Colon Cancer ◽

Specimen Extraction ◽

Laparoscopic Sigmoidectomy ◽

Transanal Specimen Extraction

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A Case of Perforated Sigmoid Colon Cancer in an Inguinal Hernia Sac Associated with Acute Renal Failure

Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) ◽

10.3919/jjsa.75.1365 ◽

2014 ◽

Vol 75 (5) ◽

pp. 1365-1369

Author(s):

Ryota KOYAMA ◽

Hideaki KAWASHIMA ◽

Makoto YOSHIDA ◽

Setsuji TAKANASHI ◽

Masahiro ISHIGOOKA ◽

...

Keyword(s):

Colon Cancer ◽

Renal Failure ◽

Acute Renal Failure ◽

Inguinal Hernia ◽

Sigmoid Colon ◽

Sigmoid Colon Cancer ◽

Hernia Sac

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Internal hernia through a mesenteric defect after laparoscopic sigmoidectomy for early sigmoid colon cancer^|^mdash;a case report^|^mdash;

Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) ◽

10.3919/jjsa.73.2716 ◽

2012 ◽

Vol 73 (10) ◽

pp. 2716-2719

Author(s):

Tadashi ANAN ◽

Ken ETOH ◽

Yoshinobu MITSUYAMA ◽

Masaichi OGAWA ◽

Nobuo OMURA ◽

...

Keyword(s):

Colon Cancer ◽

Case Report ◽

Sigmoid Colon ◽

Internal Hernia ◽

Sigmoid Colon Cancer ◽

Mesenteric Defect ◽

Laparoscopic Sigmoidectomy

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Four cases of laparoscopic colectomy for sigmoid colon and rectal cancer with persistent descending mesocolon

Surgical Case Reports ◽

10.1186/s40792-020-00988-6 ◽

2020 ◽

Vol 6 (1) ◽

Author(s):

Yumi Furuichi ◽

Kensuke Kumamoto ◽

Eisuke Asano ◽

Akihiro Kondo ◽

Jun Uemura ◽

...

Keyword(s):

Colorectal Cancer ◽

Rectal Cancer ◽

Colon Cancer ◽

Sigmoid Colon ◽

Laparoscopic Colectomy ◽

Sigmoid Colon Cancer ◽

Common Trunk ◽

Laparoscopic Sigmoidectomy ◽

Enhanced Ct ◽

Descending Colon

Abstract Background Persistent descending mesocolon (PDM) is a congenital anomaly associated with the failure of fixation of the descending colon to the lateral abdominal wall. In the laparoscopic colectomy for colorectal cancer, it has been noticed that there are extensive adhesions and a distinctive anatomy of colonic vessels in cases with PDM. Therefore, it is necessary to have sufficient knowledge about PDM so that it can be appropriately treated during surgery. Case presentation Case 1—a 79-year-old man underwent laparoscopic intersphincteric resection for rectal cancer. Preoperative barium enema (BE) revealed that the sigmoid colon was located at the right side of the abdomen. An enhanced computed tomography (CT) showed that the common trunk of the left colic artery (LCA) and the first sigmoid colonic artery (S1) branched from the inferior mesenteric artery (IMA). Case 2—a 68-year-old man underwent laparoscopic sigmoidectomy for sigmoid colon cancer and laparoscopic distal gastrectomy for gastric cancer synchronously. BE showed that the descending colon ran from the splenic flexure to medial caudal side. An enhanced CT showed that the distance from the LCA to the marginal artery was 1.0 cm. Case 3—a 68-year-old man underwent laparoscopic low anterior resection for rectal cancer. BE showed that the descending colon ran to the medial caudal side. An enhanced CT showed that the mesentery of the descending colon was comparatively shortened. Case 4—a 60-year-old man underwent laparoscopic sigmoidectomy for sigmoid colon cancer. An enhanced CT showed that the descending colon ran to the medial caudal side and predicted that the LCA and S1 formed a common trunk and branched radially from the IMA. We reported four cases with PDM recognized preoperatively as above. Three cases had a shortening of the mesocolon. While dissecting the vessels, although special attention was required to maintain the blood flow to the intestine, none of these cases developed any complications during the postoperative course. Conclusions We considered that it is important to have positional awareness of the LCA and the marginal artery to perform the laparoscopic surgery safely when a colorectal cancer with PDM is diagnosed preoperatively using imaging methods.

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