Simultaneous Totally Laparoscopic Distal Gastrectomy and Anterior Resection for Synchronous Gastric and Colon Cancer.

Beslen Goksoy

doi:10.7759/cureus.15692

Abstract

Although simultaneous open surgery for synchronous gastric and colon cancer has been reported frequently to date, total laparoscopic resection has been documented rarely. A 63-year-old male patient who presented with complaints of abdominal pain and constipation was diagnosed with synchronous gastric and sigmoid colon cancer. Simultaneous total laparoscopic distal gastrectomy (Roux-en-Y anastomosis and D2 lymph node dissection) and anterior resection were performed with a total of five ports. Total operation time was 310 min. and estimated blood loss was 175 mL. Histopathological examination result was reported as well-differentiated adenocarcinoma for the stomach and moderately differentiated adenocarcinoma for the colon. Staging result was Stage IIA (pT3N0M0, American Joint Committee on Cancer (AJCC) 8th Edition) for both cancers. The patient received postoperative adjuvant chemotherapy. He remains under follow-up at 21 months without any recurrence. With the improved techniques and increased experience in minimally invasive surgery, combined laparoscopic curative resection can be safely performed for gastric and colon cancer.

Highlights

According to Global Cancer Statistics 2020 (GLOBOCAN 2020) data, colorectal cancer ranks third and gastric cancer ranks fifth in the incidence of solid organ cancers worldwide [1]
The incidence of synchronous cancer in addition to gastric cancer is a rare condition seen at a rate of 2.5% to 3.4%, where the most common another primary cancer is colorectal cancer (20.7%) followed by lung (12%), and liver (11%) [2,3]
We present a case who underwent simultaneous total laparoscopic curative resection for synchronous gastric and sigmoid colon cancer

Summary

Introduction

According to Global Cancer Statistics 2020 (GLOBOCAN 2020) data, colorectal cancer ranks third and gastric cancer ranks fifth in the incidence of solid organ cancers worldwide [1]. A 63-year-old Turkish male patient applied to the general surgery outpatient polyclinic with complaints of abdominal pain and constipation ongoing for nearly one year but increased in the past two months His medical history revealed that the patient received medical treatment due to hypertension and anxiety disorder. How to cite this article Goksoy B (June 16, 2021) Simultaneous Totally Laparoscopic Distal Gastrectomy and Anterior Resection for Synchronous Gastric and Colon Cancer. Carcinoembryonic antigen (CEA) was 0.819 ng / mL, and cancer antigen 19-9 (CA 19-9) was 37 U / mL preoperatively Based on these findings, a decision was made to perform simultaneous total laparoscopic distal gastrectomy (Roux-en-Y anastomosis and D2 lymph node dissection) + anterior resection. The operating surgeon had experience in more than 50 open cases and in 30 laparoscopic cases for gastric cancer as well as more than 60 open cases and more than 80 laparoscopic cases for colorectal cancer

Surgical procedures

Discussion

Conclusions

Findings

Disclosures