A Case of Laparoscopic Resection of a Lymph Node Recurrence after Surgery for Descending Colon Cancer

Abstract The patient was an 81-year-old woman who underwent laparoscopic anterior resection for her descending colon cancer with final pathology results of tub2, pT3(SS), int, INFb, ly0, v1, EX(-), no lymph metastasis, and fStage II . She was followed up without adjuvant chemotherapy. Six months after the surgery, a CT scan revealed a tumor shadow 8mm in diameter near the clip fixed around the inferior mesenteric vein(IMV). After another 3 months, the tumor size increased to 11mm and it was diagnosed as a recurrence. Chemotherapy with capecitabine and bevacizumab was carried out for 6 months. Since her treatment response was judged as PR and no other recurrence was found, a local resection was planned. In order to identify the exact location of the recurrent lesion, a small laparotomy was performed at first to identify the tumor via palpation. A laparoscopic surgery was then performed to remove the recurrent lesion. Based on a pathological examination, the tumor was diagnosed as a lymph node recurrence and the histological response was judged as Grade 1b. A laparoscopic approach is technically feasible even for resection of recurrent lesions.