The incidence of synchronous cancer in gastric cancer patients has been reported to vary from 0.7% to 3.5%. Among them, colorectal cancer represents a most common synchronous cancer. We report here our minimally invasive laparoscopic treatment of synchronous gastric and colorectal cancer.
Case 1: A 72-year-old male with colon polyp underwent upper GI endoscopy that revealed a 0-IIc lesion in the middle portion of the stomach. He underwent laparoscopy-assisted pylorous-preserving gastrectomy followed by partial resection of the ascending colon using 5 ports. In this procedure, entire right colon was mobilized after dissecting right side of the gastrocolic ligament. Resection of the both lesions and reconstructions were performed through the 5cm-wound in the upper abdomen.
Case 2: A 71-year-old male with 0-III+IIc lesion in the gastric cardia underwent lower GI series preoperatively that revealed a Type 2 lesion in the upper rectum. He underwent totally laparoscopic proximal gastrectomy combined with laparoscopy-assisted low anterior resection using 6 ports. The resected stomach was retrieved through the lower abdominal wound (7cm) and restorative rectosigmoidectomy was performed using a same wound.
Case 3: A 67-year-old female complaining of anemia underwent GI tract endoscopy that revealed combined Type 2 lesion in the ascending colon and 0-IIa in the middle portion of the stomach. Laparoscopy-assisted distal partial gastrectomy with lymphadenectomy and right hemicolectomy were performed. Seven ports were used and resection and reconstruction were performed through 5cm-wound in the upper abdomen.
For right-side colon cancer, it was relatively easy to resect both lesions simultaneously using a same upper abdominal wound. For left-side rectosigmoid lesion, totally laparoscopic procedure of the gastric lesion enabled the entire procedure with only a lower abdominal wound in our series.
Program Number: P264