[A case of an elderly patient who underwent single-incision laparoscopic surgery for small intestine cancer].
An 81-year-old man presented with chief complaints of abdominal pain and vomiting. Intestinal obstruction was found at the time of admission to a local hospital in October 2011. Conservative treatment provided symptomatic relief; however, he was readmitted with similar symptoms in December 2011. Small-intestinal wall thickening was detected by abdominal and pelvic computed tomography, and he was referred to our hospital. Small-bowel endoscopy revealed an elevated subcircumferential tumor in the jejunum. Biopsy revealed well to moderately differentiated adenocarcinoma diagnosed as jejunal cancer, which caused narrowing of the jejunum. Single-incision laparoscopy-assisted small-bowel resection was performed. The intraoperative findings were a tumor with inflammatory changes in the jejunum and enlarged surrounding lymph nodes. We performed regional lymph node dissection. Histopathological analysis showed moderately differentiated small-intestinal tubular adenocarcinoma and 2 of 5 lymph nodes positive for metastatic cancer cells. After an uneventful postoperative course, he was discharged on day 7. He preferred not to undergo postoperative adjuvant chemotherapy and quickly recovered his activities of daily living postoperatively. He stayed home until he developed abdominal distention resulting from peritoneal recurrence 1 year and 6 months postoperatively and died 1 month later.
Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences.
Yoshifumi
Y
Hashimoto
Hitoshi
H
Kameyama
Yuki
Y
Hirose
Ryoma
R
Yagi
Mae
M
Nakano
You
Y
Sato
Tomoki
T
Kido
Hiroshi
H
Ichikawa
Takaaki
T
Hanyu
Masato
M
Nakano
Takashi
T
Ishikawa
Yoshifumi
Y
Shimada
Takashi
T
Kobayashi
Jun
J
Sakata
Masahiro
M
Minagawa
Shinichi
S
Kosugi
Yu
Y
Koyama
Toshifumi
T
Wakai
D000230:Adenocarcinoma / Q000150:complications / Q000601:surgery*; D000369:Aged, 80 and over; D017809:Fatal Outcome; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology / Q000601:surgery; D007580:Jejunal Neoplasms / Q000150:complications / Q000473:pathology / Q000601:surgery*; D010535:Laparoscopy; D008297:Male; D012008:Recurrence