Rectovaginal Fistula after Low Anterior Resection for Rectal Cancer Using a Double Stapling Technique

A 55-year-old female underwent low anterior resection for rectal cancer using a double stapling technique. She developed a rectovaginal fistula on the 9th postoperative day. She was discharged from hospital after undergoing transverse colostomy, and 5 months later she underwent transvaginal repair of the rectovaginal fistula. She subsequently had an uneventful recovery. The leading cause of this complication is involvement of the posterior wall of the vagina in the staple line when firing the circular stapler. Transvaginal repair with a diverting stoma for rectovaginal fistula is a safe, minimally invasive and effective method

Gastric Metastasis from a Primary Renal Leiomyosarcoma

Primary leiomyosarcoma of the kidney is rare. Here we report a case of metastasis of this tumor to the stomach. A 73-year-old man visited our hospital suffering from general weakness and intermittent tarry stools. He had undergone right nephrectomy for renal leiomyosarcoma 2 years previously. There had been no local recurrence or distant metastasis in the 2-year follow-up period. Endoscopy revealed two submucosal tumors in the stomach. These tumors were diagnosed histologically as leiomyosarcoma and distal gastrectomy was performed. Subsequent histochemical staining confirmed the diagnosis of gastric metastasis from renal leiomyosarcoma. The patient died due to metastases to the liver and bone 9 months after the operation. To the best of our knowledge, this is the first report of gastric metastasis from primary renal leiomyosarcoma

アラキドンサン タイシャ サンブツ ジョウミャクナイ トウヨ ニヨル モルモット キドウ カビンセイ ケイセイ ト ソノ キジョ ニカンスル キソテキ ケンキュウ

筑波大学博士 (医学) 学位論文・平成10年4月30日授与 (乙第1423号