Abstract
A 64-year-old woman whose stool examination was positive for occult blood at a medical checkup was diagnosed with sigmoid colon cancer by colonoscopy. Preoperative 3D-CT scan showed a horseshoe kidney and the presence of an extra renal artery feeding the inferior pole of the kidney. Sigmoid colon cancer, cSS, cN1, cM0, and cStage IIIa, was diagnosed, and we performed laparoscopic high anterior resection of the rectum + D3 dissection. During the surgery, we could confirm that the lumber splanchnic nerve had pursued on the anterior aspect of the kidney. Furthermore the extra renal artery was identified from just the tail side of the inferior mesenteric artery (IMA). Even for patients with sigmoid colon cancer associated with horseshoe kidney who can have other anatomical anomalies, keeping the same proper dissecting layer as usual would make safe laparoscopic operation possible without causing unexpected injuries.
