title: Two-port hand-assisted laparoscopic surgery for the 2-stage treatment of a complete bowel obstruction by left colon cancer: a case report.
abstract: A 69-year-old woman presented to her local clinic with vomiting and abdominal distension. Since a bowel obstruction by left colon cancer was suspected due to a marked dilation of the transverse colon, she was referred to our hospital. On admission, an enema disclosed a complete obstruction at the splenic flexure of the colon. An emergency operation was performed, and a temporary loop colostomy was fashioned on the left side of the transverse colon within the range of resection for 2-stage radical surgery. On hospital day 16, a left hemicolectomy D2 was performed by 2-port hand-assisted laparoscopic surgery (2P-HALS) using the stoma as the hand access site, and the tumor was resected along with the removal of the stoma. After surgery, a slight wound infection occurred at the hand access site, but this healed with conservative management. On day 36, she was discharged from hospital. The histological diagnosis was Type 2 circumferential well-differentiated adenocarcinoma with local peritoneal dissemination. Our experience suggests that 2-stage surgery combined with 2P-HALS is applicable even to a large obstructing left colon cancer. This method is less invasive, safe and achieves excellent results, including a good cosmetic outcome.
authors: Tokai University Hachioji Hospital, Department of Surgery, Tokyo 192-0032, Japan. mukai.masaya@hachioji-hosp.tokai.ac.jp
authors: Masaya
authors: M
authors: Mukai
authors: Akira
authors: A
authors: Tanaka
authors: Takayuki
authors: T
authors: Tajima
authors: Maki
authors: M
authors: Fukasawa
authors: Takeshi
authors: T
authors: Yamagiwa
authors: Ken-Ichi
authors: K
authors: Okada
authors: Kazuhiko
authors: K
authors: Sato
authors: Kousuke
authors: K
authors: Tobita
authors: Yasuhisa
authors: Y
authors: Oida
authors: Hiroyasu
authors: H
authors: Makuuchi
mesh_terms: D000368:Aged; D003110:Colonic Neoplasms / Q000150:complications*; D005260:Female; D006801:Humans; D007415:Intestinal Obstruction / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods*