Abstract
症例は84歳の男性で，貧血症状を契機に横行結腸癌と診断された．画像診断にて腫瘍は十二指腸下行脚に浸潤して瘻孔を伴い，さらに腫瘍から胃結腸静脈幹を経由して上腸間膜静脈に至る腫瘍塞栓を認めた．術中所見では腹膜播種や肝転移は認めずR0切除可能と判断し，右半結腸切除術および上腸間膜静脈合併切除再建を伴う亜全胃温存膵頭十二指腸切除術を施行した．病理組織学的検査所見は，pT4b（十二指腸），pN0，pStage IIc，R0，Cur Aであり，術後9カ月経過した現在，無再発生存中である．他臓器浸潤や腫瘍塞栓を伴う局所進行大腸癌でもR0切除できれば良好な予後が期待できるため，腫瘍の進展に応じた術式の工夫が必要である．
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