Precision CT‑guided marking with India ink and microcoils for laparoscopic resection of a lateral lymph node recurrence of rectal cancer: A case report

Furukawa,Shunsuke; Hiraki,Masatsugu; Oda,Takeshi; Takahashi,Yukihiko; Samejima,Ryuichiro

doi:10.3892/ol.2024.14399

Precision CT‑guided marking with India ink and microcoils for laparoscopic resection of a lateral lymph node recurrence of rectal cancer: A case report

Authors:
- Shunsuke Furukawa
- Masatsugu Hiraki
- Takeshi Oda
- Yukihiko Takahashi
- Ryuichiro Samejima
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Affiliations: Department of Surgery, Japanese Red Cross Society Karatsu Red Cross Hospital, Karatsu, Saga 847‑8588, Japan, Department of Radiology, Japanese Red Cross Society Karatsu Red Cross Hospital, Karatsu, Saga 847‑8588, Japan
Published online on: April 12, 2024 https://doi.org/10.3892/ol.2024.14399
Article Number: 266
Copyright: © Furukawa et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Although rarely used in laparoscopic surgery, computed tomography (CT)‑guided marking is useful for targeting small lesions. The present study describes the performance of laparoscopic resection with preoperative CT‑guided marking for lateral lymph node recurrence of rectal cancer. A 48‑year‑old man underwent laparoscopic low anterior resection with D3 lymph node dissection for rectal cancer (postoperative diagnosis, stage IIIb). Postoperative adjuvant chemotherapy was then administered. Solitary lymph node recurrence was observed in the left lateral region after 6 months. Systemic chemotherapy reduced the size of the metastatic lymph nodes; however, 3.5 years after the surgery, the diameter increased by 10 mm, and laparoscopic resection was thus planned. Because the target lesion was small and located deep in the pelvis, preoperative CT‑guided marking was performed with India ink injection and embolization microcoil implantation. The markers were clearly identified and the lesion was successfully resected with adequate margins. The approach described in the present study is thus considered potentially useful for the detection of small lesions.

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