PMC6275212_01
(a) Abdominal CT revealed construction findings of ileocecal and irregularity of the urinary bladder wall (white arrow). (b) Contrast-enhanced CT revealed a strong contrast effect (white arrow).
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Abdominal computed tomography (CT) revealed ileocecal bowel obstruction and irregularity in the urinary bladder wall (Fig. 1a). For diagnosis of stage, contrast-enhanced CT was performed (Fig. 1b), which suggested lymph node metastasis (No #201, #283); however no distant metastasis was observed.
Circles show port arrangement.. No 2 and 3 are 12 mm port and No 1, 4, 5 are 5 mm port.. No 1 is 2.5 cm cranial side from umbilicus.. No 3 is 2.5 cm caudal side from umbilicus.. An ileal urinal conduct was constructed at No 2 post site.
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With the patient in the lithotomy position under general anesthesia, ports were placed as shown in Fig. 2.
Three months after surgery, abdominal CT revealed metastatic tumor in para-aortic lymph nodes and spine (12th thoracic spine, 3th lumber spine and 5th lumber spine).
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Follow-up CT conducted 3 months after the patient's refusal to undergo adjuvant therapy revealed a metastatic tumor in the spine and para-aortic lymph nodes (Fig. 3), and the patient was diagnosed as having a recurrence of bladder cancer.