A Case of Laparoscopic Low Anterior Resection for Rectal Cancer with Lumboperitoneal Shunt

Ueda Masami, Ikenaga Masakazu, Tanaka Jun, Tsuda Yujiro, Nakashima Shinsuke, Ohta Katsuya, Adachi Shinichi, Endo Shunji, Yamada Terumasa

doi:10.4030/jjcs.42.829

<p>A 60-year old man, who had previously undergone lumboperitoneal shunt (LPS) operation for secondary hydrocephalus, following neurosurgical clipping for subarachnoid hemorrhage, visited our hospital after the diagnosis of rectal cancer with lung metastasis. Colonoscopy demonstrated a circumferential tumor in the rectum, below the peritoneal reflection, and CT revealed right pulmonary metastasis. Considering that the LPS tube featured anti-reflex valve shunt system, we concluded that it was possible to perform laparoscopic surgery on the patient, under common pneumoperitoneum pressure, without the manipulation of the LPS. During surgery, the LPS tube was located on the left side of the abdominal cavity. We accomplished laparoscopic low anterior resection under pneumoperitoneum pressure of 10 mmHg, with no complication. Additionally, we performed diverting ileostomy and inserted a drainage tube, considering the possibility of sutura leakage. On the 17th day of hospitalization, the patient was discharged with no complications. Our experience indicates that in patients with colorectal cancer, who had been previously treated with LPS tube with pressure control valve, laparoscopic surgery can be safely performed under common pneumoperitoneum pressure.</p>

A Case of Laparoscopic Low Anterior Resection for Rectal Cancer with Lumboperitoneal Shunt

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