A two-step laparoscopy-assisted curative resection for a patient with obstructive colitis accompanied by advanced...

This report presents the case of a two-step laparoscopic resection and reconstruction for obstructive colitis accompanied by advanced sigmoid colon cancer. An 81-year-old woman was admitted with a diagnosis of ileus. Computed tomography revealed a circumferential tumor in the sigmoid colon and a diffuse dilated large intestine on the oral side of the tumor. On the 7th day after admission, her temperature was 38.8°C, she had increased white blood cell count (24 610 cells/mm(3)), and suffered persistent severe abdominal pain. An emergency laparoscopy-assisted Hartmann procedure was performed, based on a tentative diagnosis of obstructive colitis due to sigmoid colon cancer. The descending colon and residual rectum were anastomosed laparoscopically by double-stapling technique 6 months after the initial surgery. Her postoperative course was uneventful for both procedures and she was discharged after 10 and 18 postoperative days, respectively. This case demonstrates that an initial laparoscopic emergency excision followed by a later reconstruction might be a safe and simple surgical technique for patients with obstructive colitis accompanied by left-sided colon carcinoma.