Laparoscopic Colectomy for Sigmoid Colon Cancer in a Patient With a History of Radical Cystectomy and Ileal Conduit Urinary Diversion

A 72-year-old man who underwent laparoscopic radical cystectomy and ileal conduit construction for bladder cancer exhibited sigmoid colonic wall thickening and metastatic liver and lung lesions on surveillance CT. Colonoscopy revealed semicircular type 2 advanced sigmoid colon carcinoma. The primary tumor and metastases were resectable. However, preoperative weight reduction was prioritized owing to the patient's BMI of 35.5. Chemotherapy was administered during their weight loss. After 2 months, the patient's BMI decreased to 32.2, and elective surgery was performed. Anatomical alterations rendered preoperative placement of fluorescent ureteral stent unfeasible. Three-dimensional CT reconstruction was used for preoperative planning. Intraoperatively, careful dissection of adhesions between the left iliac vessels and the sigmoid colon helped identify the left ureter near the sacral promontory, ensuring safe resection. Patient recovery was uneventful. Patients undergoing ileal conduit owing to bladder cancer require prior surgical records, preoperative imaging, and precise intraoperative techniques for surgical planning and urinary tract preservation.