Abstract:
Managing colon cancer with intestinal nonrotation, a type of congenital intestinal malrotation, is challenging due to the presence of anatomical abnormalities and severe adhesions. When patients have nonrotation, it is markedly more difficult to determine which vessels correspond to the colic vessels and ileal vessels until all vascular branching patterns become evident. The optimal approach for right-sided colon cancer with intestinal nonrotation has yet to be established. In the present case of ascending colon cancer with intestinal nonrotation, we performed laparoscopic right hemicolectomy with D3 dissection using a modified cranial approach. This approach involves tracing, without resecting, branches from the superior mesenteric vein and superior mesenteric artery in a cranial-to-caudal manner until the ileocolic artery and ileocolic vein, which course toward the cecum, are identified, followed by the dissection of the colic vessels and lymph nodes in a caudal-to-cranial fashion.
摘要:
处理肠道非旋转的结肠癌,一种先天性肠旋转不良,由于存在解剖异常和严重的粘连,因此具有挑战性。当患者没有旋转时,在所有血管分支模式变得明显之前,确定哪些血管对应于绞痛血管和回肠血管明显更加困难。肠道非旋转右侧结肠癌的最佳治疗方法尚未确定。在目前的升结肠癌与肠道非旋转的情况下,我们采用改良的颅部入路进行了腹腔镜右半结肠切除术和D3夹层.这种方法涉及跟踪,不切除,从肠系膜上静脉和肠系膜上动脉的分支从颅到尾的方式直到回肠动脉和回肠静脉,朝向盲肠,被识别,然后以尾至颅的方式解剖绞痛血管和淋巴结。