生体腎移植後に子宮頸癌を発症した症例に対して、発光式尿管カテーテル（Infrared illumination system）を用いて腹腔鏡下広汎子宮全摘術を施行した１例

抄録

　Approximately 1,700 cases of renal transplantation are performed annually, and various diseases may occur due to long-term internal use of postoperative immunosuppressants. We experienced a case of cervical cancer, which is thought to be human papillomavirus (HPV)-related after a living kidney transplantation, underwent laparoscopic radical hysterectomy.

　A 42-year-old woman underwent living kidney transplantation at the age of 30 years. An increase of CA19-9 was recognized during the follow-up after transplantation. Cervical cytology detected squamous cell carcinoma (SCC); therefore the case was referred to our department. A diagnostic cone resection was performed, and a laparoscopic radical hysterectomy under the diagnosis of cervical cancer stage IB1, was performed. Luminescent ureter catheters were placed on both sides of the ureter, and a DJ stent was placed in the transplant ureter. The right post-peritoneal cavity was difficult to develop due to adhesion. On the left side, radical hysterectomy and pelvic lymph node dissection were performed (pT1bN0M0). Vulvar intra-epithelial neoplasia 3 (VIN3) developed 12 months after the operation and was removed.

　Following a renal transplantation procedure, close monitoring of the transplanted kidney and transplant ureter is required. Laparoscopic surgery and navigation with a luminescent ureteral catheter are useful methods for avoiding perioperative complications. In addition, in HPV-related cervical cancer, which is considered to be the effect of immunosuppressants, attention should be paid to other new lesions, and careful follow-up is important.