Abstract

Aggressive radical R0 resection is necessary for good prognosis in colorectal cancer with adjacent organ invasion. According to the location of the tumor, various pelvic organs are removed in en-block resection. However, en-block resection may be challenging in case with vascular invasion such as external iliac vessels because vascular specialist should be involved and vascular reconstruction is complex procedure than any other surgical procedure. We report the case of a 53-year-old man who underwent curative surgery for rectosigmoid colon cancer invading the left external iliac artery (EIA) and vein (EIV). En-bloc resection of the tumor including external iliac vessels and ureter was performed, and the resected EIA and EIV were reconstructed using the internal iliac artery and vein. This procedure is more physiologic than extra-anatomic bypass and eliminates the need of artificial graft. Consequently, its use may improve patency and decrease the risk of graft infection.

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