PMID- 32156908
OWN - NLM
STAT- MEDLINE
DCOM- 20200421
LR  - 20200421
IS  - 0385-0684 (Print)
IS  - 0385-0684 (Linking)
VI  - 46
IP  - 13
DP  - 2019 Dec
TI  - [Transverse Colectomy with D2 Lymph Node Dissection with a Small Incision Using 
      Body Surface 3D-Simulation CT Colonography].
PG  - 2291-2293
AB  - BACKGROUND: Laparoscopic transverse colectomy is technically difficult. In 
      mini-laparotomy surgery, colectomy for midtransverse colon cancer can easily be 
      performed, but exact D2 lymph node dissection is very difficult for a variety of 
      vessels in the transverse colon. Using 3D-CT imaging, we present a case of D2 
      lymph node dissection where mini-laparotomy transverse colectomy was performedby 
      a small incision similar to that usedin laparoscopic surgery. METHOD: The patient 
      was a 60-yearoldwoman with early transverse colon cancer, which was locatedin the 
      mid-transverse colon. Surgical treatment was plannedfor pT1b(1.5mm)andpVM1 in 
      pathological findings after EMR. Using CT colonography(CTC), the location of the 
      primary tumor was identified. Using simulation CTC(sCTC), composedof CTC and 3D 
      imaging of the arteries andveins, the dominant artery was identified and D2 lymph 
      node dissection was simulated. In addition, body surface 3D imaging and permeable 
      surface 3D imaging of the abdominal trunk were performed. Using body surface 
      3D-sCTC, composedof sCTC and body surface 3D imaging, the minimum incision to 
      enable D2 lymph node dissection was simulated. RESULT: Using sCTC, it was 
      identified that the dominant artery was the right branch of the middle colic 
      artery(MCA Rt)andthe accompanying vein was branchedfrom the gastrocolic 
      trunk(GCT). D2 lymph node dissection to separate the branching root of MCA Rt and 
      the accompanying vein was simulated. Next, surgical incision was simulated using 
      body surface 3D-sCTC. Because the branching roots of MCA Rt andGCT were 
      locatedabout 5 cm cranial from the upper rim of the navel, a 7 cm upper abdominal 
      midline incision was designed in addition to a 2 cm umbilical incision. 
      Mini-laparotomy transverse colectomy with a 7 cm incision was performedin 
      accordance with the simulation. The operation time was 2 hours and5 1 minutes, 
      andbloodloss was due to occult bleeding. The patient was discharged 7 days after 
      surgery without complications, and the final diagnosis was pT1bN0M0, StageⅠwith 
      no recurrence for 4 years and2 months after surgery. The cranial incision from 
      the upper rim of the navel has shrank about 3 cm, and the umbilical incision is 
      not noticeable. CONCLUSION: D2 lymph node dissection of minilaparotomy transverse 
      colectomy can be a treatment option for early transverse colon cancer through 
      using body surface 3DsCTC.
FAU - Narushima, Kazuo
AU  - Narushima K
AD  - Dept. of Surgery, Teikyo University Chiba Medical Center.
FAU - Shuto, Kiyohiko
AU  - Shuto K
FAU - Kosugi, Chihiro
AU  - Kosugi C
FAU - Mori, Mikito
AU  - Mori M
FAU - Hosokawa, Isamu
AU  - Hosokawa I
FAU - Fujino, Masafumi
AU  - Fujino M
FAU - Takahashi, Masahiko
AU  - Takahashi M
FAU - Yamazaki, Masato
AU  - Yamazaki M
FAU - Shimizu, Hiroaki
AU  - Shimizu H
FAU - Miyazawa, Yukimasa
AU  - Miyazawa Y
FAU - Koda, Keiji
AU  - Koda K
FAU - Miyauchi, Hideaki
AU  - Miyauchi H
FAU - Ohira, Gaku
AU  - Ohira G
FAU - Hayano, Kouichi
AU  - Hayano K
FAU - Matsubara, Hisahiro
AU  - Matsubara H
LA  - jpn
PT  - Case Reports
PT  - Journal Article
PL  - Japan
TA  - Gan To Kagaku Ryoho
JT  - Gan to kagaku ryoho. Cancer & chemotherapy
JID - 7810034
SB  - IM
MH  - Colectomy
MH  - Colon, Transverse/*surgery
MH  - *Colonic Neoplasms/surgery
MH  - *Colonography, Computed Tomographic
MH  - Female
MH  - Humans
MH  - *Laparoscopy
MH  - Lymph Node Excision
MH  - Middle Aged
MH  - Neoplasm Recurrence, Local
MH  - *Surgical Wound
EDAT- 2020/03/12 06:00
MHDA- 2020/04/22 06:00
CRDT- 2020/03/12 06:00
PHST- 2020/03/12 06:00 [entrez]
PHST- 2020/03/12 06:00 [pubmed]
PHST- 2020/04/22 06:00 [medline]
PST - ppublish
SO  - Gan To Kagaku Ryoho. 2019 Dec;46(13):2291-2293.