Metachronous tumour recurrence after total colectomy and ileorectal anastamoses for cancer colon.The recurrent Tumor was obstructing the lower ureter and infiltrating the left illiac vessels. A left lower ureterectomy with excision of left internal iliac artery and partial excision of left external ilac vein along the whole tumor was done with subsequent reconstruction. Dr Arindam Ghosh Mch Gastrosurgeon Advanced laparoscopic ,onco Bariatric & Liver transplant Surgeon Website www.drarindamghosh. com