Simultaneous Laparoscopy-Assisted Resection for Synchronous Gastric and Colorectal Cancer

Byung-kwon Ahn, Seung-hyun Lee, Joong-jae Yoo, Sung-uhn Baek, Ki-young Yoon. Department of Surgery, Kosin University College of Medicine, Busan, South Korea


Purpose: Colorectal and gastric cancers are sometimes diagnosed as a synchronous carcinoma. Simultaneous surgical resection with lymphadenectomy is indicated for both cancers, if there is no other distant metastasis and curative resection is expected. Increasingly, laparoscopy-assisted resection for gastric or colorectal cancers is being performed. However, simultaneous laparoscopy-assisted resection for both cancers is rarely documented and its feasibility unknown. The purpose of this study is to evaluate feasibility and safety of simultaneous laparoscopic resection as compared to open surgery for colorectal and gastric cancers.
Methods: From January 2001 to December 2009, a total of 25 patients underwent simultaneous resection for colorectal cancers and synchronous gastric cancers. Three patients (2 male; age range 49-68 years) underwent laparoscopy-assisted resection (LAP group) and twenty two patients (17 male; age range 47-76 years) underwent open surgery (Open group) for gastric cancer and colorectal cancer as curative intention. In open group, one patient was excluded, which had a colorectal cancer, a gastric cancer and a thyroid cancer, synchronously.
Results: The mean age (61.7 vs. 63.7 years, p =0.613), body mass index (24.6 vs. 22.3, p = 0.039), anterior resection for colorectal cancer (66.7% vs. 65.0%, p = 0.102) was comparable in the two groups, respectively. In LAP group, laparoscopic-assisted distal gastrectomy was performed for all three patients. In Open group, subtotal gastrectomy with billroth I gastroduodenostomy was most common procedure (66.7%). The operation time, blood loss volume was similar between the two groups. Gas out was earlier (2.7 vs. 4.6 days p = 0.068), postoperative hospital stay was shorter (14.7 vs. 18.2 days, p = 0.715) in LAP group. The postoperative complications were an ileus and a wound seroma in LAP group, pneumonia (10.0%), wound bleeding (5.0%) and leakage (5.0%) in Open group. Conclusion: The simultaneous laparoscopy-assisted resection for synchronous gastric and colorectal cancer is a feasible and safe procedure and should be indicated, provided it is performed by an experienced surgeon.

Session Number: SS20 – Colorectal
Program Number: S118

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