[A Case of Surgery for Transversal Colon Cancer with Intestinal Malrotation -Visualizing Method of Blood Flow in the Fluorescence Navigation Period].

Background: Anastomotic blood flow evaluation using the fluorescence method with indocyanine green(ICG)is expected to decrease the risk of anastomotic leakage in colorectal cancer surgery. The fluorescence method is considered to be also useful for assessing arterial divergence patterns in patients with special anatomical features. We report a case of transverse colon cancer with intestinal malrotation treated with laparoscopic surgery using the ICG fluorescence method.

Case: A 62- year-old woman who was diagnosed as having transverse colon cancer with intestinal malrotation underwent a laparoscopic transverse colon resection with D3 lymph node dissection. We identified the ileocolic artery and middle colic artery (MCA)after the ICG injection and the severed MCA during lymphadenectomy. We made a final diagnosis of pT2N0M0, pStage Ⅰ.

Conclusion: The fluorescence method was useful for assessing the arterial divergence pattern in a patient with a special anatomical feature. However, the ICG fluorescence method had some problems, including visualizing blood flow for only a short time and poorly transmitting the dye through thick fat.