Introduction Locally advanced colon neoplasms with invasion of adjacent organs can often pose
a challenge for achieving R0 surgery using minimally invasive techniques. Sigmoid
lesions may invade organs of the genitourinary tract, and to achieve free margins,
resection may be necessary, and, when indicated, reconstruction, as in the case of
urinary tract invasion.
Objectives Technical description of rectosigmoidectomy with the need for ureterectomy in a patient
with an advanced sigmoid tumor, where ureteral reimplantation was performed in the
psoic bladder.
Methods A 74-year-old patient presented with abdominal pain and diarrhea. Colonoscopy identified
a neoplastic lesion in the sigmoid. Staging exams showed no evidence of distant disease.
A laparoscopic resection was planned, and during the inventory, left ureter adhesion
to the tumor was identified. Ureterectomy was performed, followed by laparoscopic
ureteral reimplantation using a modified Lich-Gregoir technique.
Results The rectosigmoidectomy combined with ureteral reimplantation was successfully performed,
achieving free margins. The patient had no complications from the procedure and was
referred for adjuvant chemotherapy.
Conclusion Resection of organs and structures adhered to the tumor is crucial for obtaining
an oncologically adequate result, and performing the entire procedure via minimally
invasive surgery facilitates a faster recovery for the patient.
