Advances in diagnostic techniques and treatment have resulted an increase patients with synchronous cancer. Surgical reports of combined laparoscopic robotic resection for colorectal genitourinary cancer are rare.Between August 2015 November 2017, three underwent surgery our hospital.Case 1 was a 59-year-old man rectal prostate treated by anterior robotic-assisted prostatectomy. Case 2 77-year-old transverse colon left kidney colectomy partial nephrectomy. 3 74-year-old adenocarcinoma...

Abstract Aim The outcomes of cytoreductive surgery (CRS) for synchronous and metachronous colorectal peritoneal dissemination were investigated using the Japanese P classification cancer index (PCI). Methods CRS was performed in 111 cases 115 dissemination. PCI determined at time laparotomy. Results In group, 5‐year overall survival rates after P1/P2 P3 51% 13%, respectively. Even P3, patients achieved macroscopic complete resection (CC‐0), with a rate 40%. When classified into 0–9, 10–19,...

The double stapling technique has greatly facilitated intestinal reconstruction, particularly for anastomosis after anterior resection. However, anastomotic stenosis may occur, which sometimes requires surgical treatment. Redo surgery with reresection and reanastomosis presents a high risk of complications. Treatment methods need to be selected depending on the degree location stenosis. In an effort propose new resolution, reporting cases sharing valid experiences are necessary. An...

A 78-year-old woman with lumboperitoneal (LP) shunt was diagnosed advanced cancer of the ascending colon. Laparoscopic right hemicolectomy performed without manipulating catheter. The patient’s postoperative course uneventful, no shunt-related complications or neurological deficit. number patients cerebrospinal fluid (CSF) who require abdominal surgery has been increasing. There are only few studies on laparoscopic for LP shunt, and safety pneumoperitoneum in CSF remains controversial....

Schwannoma arises from Schwann's cell of the neural sheath. large intestine, particularly appendix, is rare. We report a case appendiceal schwannoma resected using laparoscopic surgery. A 75-year-old man was referred to our hospital for abdominal fullness and nausea since 2 months. Abdominal CT revealed well-demarcated oval mass 25 mm at tip appendix. Contrast-enhanced lesion with gradually enhanced contrast arterial phase equilibrium phase. US hypoechoic tumor. Preoperative diagnosis...

Hemorrhagic rupture is a very rare and life-threatening hepatic cyst complication. Several treatment methods have been used for hemorrhage and/or rupture; however, transcatheter arterial embolization has poorly documented. An 80-year-old man receiving dual antiplatelet therapy was diagnosed with hemorrhagic of cyst. Transcatheter using coil performed A6 branch confirmed active extravasation. His condition improved promptly after treatment, the gradually became smaller as compared to size...

The optimal management strategy for synchronous gastric cancer (GC) and prostate (PCa) remains unclear, particularly in cases which two cancers are progressive.A 68-year-old man diagnosed with advanced GC locally PCa was referred to our institution. Laparoscopic total gastrectomy (LTG) robotic-assisted radical prostatectomy were simultaneously performed. postoperative course similar the standard of LTG alone. Pathological diagnoses T3N3aM0 adenocarcinoma T3N0M0 prostatic adenocarcinoma....

The association between pancreaticoduodenal artery aneurysm (PDAA) and local hemodynamic changes in arcades is well established. However, there are few case reports of PDAA associated with acute aortic dissection. In this article, we outline discuss the a 61-year-old man diagnosed type A dissection who underwent emergency surgery developed sudden-onset severe abdominal pain shock 10 days later. Contrast-enhanced computed tomography showed ruptured feeding vessels from gastroduodenal superior...

Recently, endovascular repair has become the first-line treatment for internal iliac artery aneurysm (IIAA). However, rectal necrosis due to compression of residual IIAA early after is rare.We present a rare case huge, isolated left that severely compressed rectum and ureter. The patient underwent emergency repair; however, occurred 10 days later because failed shrink size aneurismal sac.We hypothesize caused necrosis. During open surgery, disrupted blood flow within IIAA, which probably...

The occurrence of sporadic colonic neurofibroma particularly in a patient without neurofibromatosis type 1 has been rarely reported. Therefore, the clinical significance this disease not fully elucidated. An 81-year-old woman with positive fecal occult blood test result was referred to our institution for evaluation anemia. On colonoscopy, 50-mm submucosal tumor-like mass found hepatic flexure colon. Superficial biopsy and boring showed unspecific granulation tissues, immunostaining revealed...

近年，腎癌膵転移に対する外科治療の報告が散見されるが，症例の蓄積はいまだ少なく，その治療方針には一定の見解を得ていない．今回われわれは，腎癌膵転移に対して膵体尾部切除術を施行した後，残膵に腎癌の再発を発症したため残膵全摘を施行した症例を経験したため報告する．症例は59歳男性．右腎癌術後4年に膵転移を発症し，膵体尾部切除術を施行した．術後は化学療法を施行せず経過観察とした．術後1年で残膵に腎癌の再発を発症したため残膵全摘を施行した．術後1年で腎癌の多発肝転移および後腹膜転移を発症したため化学療法を開始し，残膵全摘より術後4年生存中である．腎癌膵転移は，残膵に再発した症例に対しても積極的な外科治療を含めた集学的治療により良好な予後が得られると考えられた．

Advances in diagnostic techniques have resulted an increase the diagnosis of numerous patients with multiple primary cancers. However, synchronous colorectal cancer and bladder remains rare.A 69-year-old man diagnosed advanced ascending colon urinary underwent simultaneous laparoscopic resection. His postoperative course was similar to that routine cancer. The patient refused adjuvant therapy. as having recurrence 3 months after surgery; he died 9 surgery.For malignant tumors, tumor...

An 80-year-old man was referred to our hospital because of epigastric pain. Abdominal computed tomography revealed a well-defined circular intra-abdominal mass in the gastro-pancreatic region measuring 15 mm diameter. After 6 months, lesion growing with mild enhancement, and weaker enhancement found lower half on contrast-enhanced tomography. The touched stomach, whereas adipose tissue appeared intervene between pancreas. On magnetic resonance imaging, had isointensity muscle T1-weighted...

症例は86歳，女性．2012年2月に嘔吐を主訴に近医受診．CTで右横隔膜下から右下腹部にかけて後腹膜に進展する巨大な嚢胞性病変を認め，巨大腎嚢胞が疑われて当院泌尿器科を紹介受診した．当院のCTでは嚢胞性病変は盲腸から連続して右腎と境界を保ちつつ，その背側を通り右横隔膜下までに至ることが判明し，一部で壁の造影効果が認められた．また虫垂は同定できなかった．採血では腫瘍マーカーの上昇を認めた．以上から虫垂もしくは後腹膜由来の粘液嚢胞腺腫または腺癌が疑われ手術目的に当科紹介となった．手術は悪性の可能性を考慮して回盲部切除，D3郭清とした．嚢胞壁には厚みがあり破ることなく盲腸，上行結腸と一塊にして摘出できた．標本の大きさは25×9×8cm，病理診断は虫垂粘液嚢胞腺腫であった．退院後は近医に通院中であるが，腫瘍マーカーは正常化し，術後5カ月が経過するが再発兆候を認めていない．

Laparoscopic surgery has become a standard treatment for inguinal hernia, with it recently being characterized by the use of smaller instruments. However, reports on needlescopic transabdominal preperitoneal repair using one umbilical 5-mm and two lateral 3-mm trocars are extremely rare. Seven patients unilateral hernia underwent this surgical procedure. A trocar was inserted from were lateral. After dissection layer, mesh fixed tucker while viewing through optics trocar. All procedures...

症例は59歳，男性。腹痛を主訴に救急搬送され，腹部造影CTで前下膵十二指腸動脈瘤破裂による後腹膜血腫と診断した。動脈瘤の原因として，segmental arterial mediolysisと腹腔動脈起始部狭窄の関与が考えられた。Transcatheter embolizationを行ったが，巨大な後腹膜血腫による腹部コンパートメント症候群を発症した。メッシュによる正中の筋膜牽引とnegative pressure wound therapyを併用したopen abdominal managementを行い，状態が安定したところで後腹膜血腫の除去と筋膜閉鎖による閉腹を行って良好な転帰を得られた。

Successful nonoperative management has been reported for esophageal perforation; however, some cases require surgery.We presented the case of an 85-year-old woman with iatrogenic thoracic perforation in whom primary repair or resection perforated esophagus was difficult because she elderly and had severe aortic valve stenosis. Therefore, we selected a two-stage surgery; laparoscopic gastrostomy, jejunostomy, posterior mediastinal drainage, cervical esophagostomy were performed. We planned...

症例は67歳，男性．腹部大動脈瘤に対するY字型人工血管置換術後5日目に発熱と炎症反応の上昇を認めた．CTにて大動脈瘤内にairを認め，周囲脂肪織濃度の上昇を認めた．上部消化管造影に引き続きCTを施行し大動脈十二指腸瘻と診断し，緊急手術を行った．

Various collateral pathways maintain blood flow to the lower extremities in patients with Leriche syndrome. The occurrence of true aneurysms lumbar artery—a component an extensive circulation network syndrome—is extremely rare. A 73-year-old man syndrome was diagnosed artery aneurysm complicated by a duodenal fistula. patient underwent endovascular repair, surgical fistula closure, and debridement wall until coil exposure. With same mechanism, aortic occlusive disease may develop...