Simultaneous Laparoscopic S8 segmentectomy of liver and LADG in patient with synchronous HCC and EGC

In Seok Choi, PhD, Naksong Sung, MD, Wonjun Choi, MD, Sangeok Lee, MD, Juik Moon, MD. Department of Surgery, Konyang University Hospital, Daejeon, Korea.

Introduction: As we encounter patients diagnosed with double primary cancer, we think over a proper way of treatment. Nowadays, preferable treatment on both early gastric cancer (EGC) and hepatocellular carcinoma(HCC) is laparoscopic surgery. Various literatures have reported there are no differences with oncologic safety and feasibility between open and laparoscopic surgery for each cancer. Hereby, we report simultaneous laparoscopic S8 segmentectomy and laparoscopic-assisted distal gastrectomy (LADG) in patient with synchronous HCC and EGC

Method: 58 year-old male patient was diagnosed with EGC and HCC (S8) during cancer screening test. He presented with a 3.9 X 4cm sized HCC confirmed by ultrasound (US) – guided biopsy in segment 8 of the liver and 1cm sized EGC (signet ring cell carcinoma) that is located at great curvature of antrum, and localized at mucosa without lymphovascular invasion confirmed by Endoscopic US (EUS). Laparoscopic S8 monosegmentectomy was firstly performed with 4 ports method (umbilicus and epigastrium: 11 mm, Rt. mid-abdomen and Lt. upper abdomen: 5 mm), and LADG with D2 lymph node dissection was performed later with additional 2 ports (Rt. lower abdomen: 11mm, Lt. lower abdomen: 5mm).

Results: An operating time was 215 minutes, and estimated blood loss was 100cc. Diet was started at postoperative day 3 and discharged at postoperative day 8 without another complications

Conclusion: We suggest that simultaneous laparoscopic treatment for synchronous HCC and EGC would be safe and feasible method.

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