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Title: ロボット支援前立腺全摘除術施行後に判明した先天性右外腸骨静脈欠損の1例
Other Titles: A Case of a Congenital Right External Iliac Vein Defect Found after Robot-Assisted Radical Prostatectomy
Authors: 大山, 雄大  KAKEN_name
遠藤, 文康  KAKEN_name
新保, 正貴  KAKEN_name
小松, 健司  KAKEN_name
京野, 陽子  KAKEN_name
成本, 一隆  KAKEN_name
服部, 一紀  KAKEN_name
Author's alias: Ohyama, Takehiro
Endo, Fumiyasu
Shimbo, Masaki
Komatsu, Kenji
Kyono, Yoko
Narimoto, Kazutaka
Hattori, Kazunori
Keywords: Robot assisted radical prostatectomy
External iliac vein defect
Deep vein thrombus
Issue Date: 31-Dec-2019
Publisher: 泌尿器科紀要刊行会
Journal title: 泌尿器科紀要 = Acta urologica Japonica
Volume: 65
Issue: 12
Start page: 519
End page: 521
Abstract: Congenital external iliac vein defects are extremely rare. A 56-year-old man underwent robotic prostatectomy (RARP) without pelvic lymph node dissection (PLND) for localized low-risk prostate cancer. Intraoperative findings revealed a markedly dilated vein on the dorsal side of the pubic bone, which was difficult to preserve and was therefore clipped. Sudden swelling and pain appeared in the right leg on day 2 after successful RARP. A contrast-enhanced computed tomography (CT) scan showed a deep vein thrombus (DVT) and lack of a right external iliac vein. Immediate heparinization improved the symptoms, and no other postoperative complications occurred. In the retrospective review, a large dilated vein lying transversely on the prostate surface was observed with a robotic scope, but no manipulation of the pelvic vessels was performed because PLND was not performed. Therefore, the dilated vein was not recognized as a shunt from the right femoral vein to the left external iliac vein. A preoperative staging CT scan, which faintly revealed the right external iliac vein, could be useful to identify this extremely rare deformity in advance of surgery. Although preoperative imaging examinations are often difficult to diagnose preoperatively, as in this case, we consider it important to use appropriate approaches and treatment when dealing with symptoms that arise during pelvic surgery in patients with many anatomical variations.
Rights: 許諾条件により本文は2021/01/01に公開
DOI: 10.14989/ActaUrolJap_65_12_519
PubMed ID: 31933337
Appears in Collections:Vol.65 No.12

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