Ureteral Reconstruction by Psoas Hitch for Colorectal Patient Combined with Lower Part Ureteral Resection—A Case Report

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  • 尿管合併切除大腸癌に対してPsoas hitch法を用いて再建した1例
  • Ureteral Reconstruction by Psoas Hitch for Colorectal Patient Combined with Lower Part Ureteral Resection—A Case Report

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For colorectal cancers invading adjacent organs, good prognosis can be expected with aggressive combined excision of adjacent organs. However, in the case of urinary tract excisions, postsurgical QOL depends on the reconstruction method; therefore, it is important to select an appropriate reconstruction technique. We report a successful case of combined excision of the ureter with colon cancer and reconstruction of the ureter using the Psoas Hitch procedure. A 75-year-old man with a chief complaint of bloody stool was diagnosed as having sigmoid colon cancer. The surgery included excision of the sigmoid colon and combined excision of the right ureter. Since the length of the excised ureter was 6 cm, the Psoas Hitch procedure was selected for ureter reconstruction. Except for mild and transient urinary frequency post-surgery, no complications were observed, resulting in good outcome and the patient has remained alive without recurrence for 18 months post-surgery. In conclusion, in this colon cancer patient in whom cancer invasion to the lower urinary tract was suspected, since end-to-end anastomosis was impossible due to large excision of the ureter, the Psoas Hitch procedure enabled ureter reconstruction as well as radical cure and safety. The current method is expected to be useful for ureter reconstruction when large excision of the ureter is required.

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