A Case of Laparoscopic Abdominoperineal Resection for Rectal Cancer with Ventriculoperitoneal Shunt

Abstract

Ventriculoperitoneal shunt (VPS) is used in the treatment of hydrocephalus caused by a cerebrovascular accident. Shunt dysfunction due to increased intra-abdominal pressure caused by pneumoperitoneum, increased intracranial pressure, and retrograde infection have been reported in patients with VPS implantation who are undergoing laparoscopic surgery ; however, there is no consensus on the intraoperative management of VPS. Here, we present a case of an 82-year-old woman who had been implanted VPS for post-hemorrhagic subarachnoid hydrocephalus. She was diagnosed with rectal cancer by a lower gastrointestinal endoscopy and was referred to our department. The diagnosis of rectal cancer was Rb cT3N0M0 Stage IIa. After consultation with the Department of Neurosurgery, we performed laparoscopic abdominoperineal resection D3LD0 with intraoperative clamping of the VPS using an anti-reflux valve. The patient was discharged from the hospital without any postoperative complications, and no obvious neurological abnormality has been observed till 10 mon postoperatively. To our knowledge, this is the first report of laparoscopic abdominoperineal resection for rectal cancer under VPS implantation.