Rectal Cancer Involving the Left Pelvic Kidney Treated Successfully Using Laparoscopic Surgery after Simulation—A Case Report—

Abstract

The case involved a 77-year-old woman presenting with bloody bowel discharge. Following a total colonoscopy rectal cancer (Ra), Type2 cT3N1M0 Stage III, was diagnosed. Then an abdominal computed tomography (CT) showed a left pelvic kidney and a right ovarian tumor. The required resection was anatomically complex, because we might have to dissect the rectal wall from the pelvic kidney on the sacral promontory. Therefore, preoperative simulation for localizing ports was performed using a sagittal CT. We performed laparoscopic low anterior resection combined with D3 lymph node dissection, right ovariectomy, and ileostomy. The operation was successful with uneventful clinical course, and she was discharged from our hospital. Preoperative detailed evaluation of imagings and devices of location of ports would permit safe resection even for rectal cancer with the pelvic kidney. As surgical cases of rectal cancer with a pelvic kidney are rare, we report on our case with a review of the literature.