Abstract
An extremely rare case of rectal cancer complicated by crossed fused ectopic kidney is reported. The patient was a 70-year-old man in whom rectal cancer was detected on colonoscopy conducted due to a positive fecal occult blood test, and who was diagnosed with crossed fused ectopic kidney during preoperative testing. Crossed fused ectopic kidney has been reported to often involve vascular and ureteral malformations, as with other renal malformations such as horseshoe kidney. In order to ensure safe surgery, it is necessary to determine the course of the vessels and ureters preoperatively. In the present case, abdominal contrast-enhanced computed tomography angiography (3D-CTA) was used to preoperatively confirm the course of the vessels and ureters. As for surgery, laparoscopic high anterior resection was performed using the medial approach. By detaching tissue along the ventral layer of the subretroperitoneal fascia, the ureters, gonadal arteries and veins, and autonomic nerves were preserved on the dorsal side, and surgery could be completed without damaging them. The present case suggests that, even in cases complicated by renal malformations, laparoscopic surgery can be safely performed by maintaining the correct detachment layer.
