A Case of Synchronous Rectal Cancer and Right Sided Colon Cancer Treated with Transvaginal NOSES Technique

Abstract

Introduction: We reported a 53 years old female patient with synchronous rectal cancer and right sided colon cancer who underwent transvaginal NOSES to resect two tumors with no serious postoperative complications. Case report: The patient underwent electronic colonoscopy and found two lesions in the intestine, located in the right colon and rectum. Pathological examination confirmed that both lesions were malignant tumors, and the patient was diagnosed with concurrent colon and rectal cancer. After diagnosis, the patient underwent transvaginal NOSES, and the intraoperative exploration results were consistent with electronic colonoscopy. The surgery completely resected two malignant tumors at same time. The pathological report staging of right colon cancer is AJCC stage II (pT3N0M0), with moderately differentiated adenocarcinoma and negative circumferential margin. The pathological report staging of rectal ancer is AJCC stage IIIpT2N1aM0), with moderately differentiated adenocarcinoma and negative circumferential margin. The patient recovered well after surgery and did not experience any serious postoperative complications. Patient receives XELOX chemotherapy after surgery. Discussion: Transvaginal NOSES is a safe and effective surgical method for synchronous multiple primary colorectal cancer. However, due to the complexity of the surgery and the increased anesthesia risks associated with additional surgical time, experienced surgical and anesthesia teams are required. Conclusion: The application of transvaginal NOSES in the treatment of synchronous multiple primary colorectal cancer is still in the exploratory stage, and more clinical studies are needed to prove its feasibility, safety, and effectiveness.