title: Endolaparoscopic left hemicolectomy and synchronous laparoscopic radical nephrectomy for obstructive carcinoma of the descending colon and renal cell carcinoma.
abstract: Colorectal self-expandable metal stents (SEMS) have been used successfully as preoperative bridges to surgery for obstructive left-sided colorectal carcinoma. Endoscopic relief of the obstruction allows for full bowel preparation and accurate preoperative staging. A laparoscopic approach, considered by many to be contraindicated in the presence of obstruction, becomes feasible after endoscopic decompression. We present a case of obstructive carcinoma of the descending colon successfully treated with endoscopic decompression with colorectal SEMS. Subsequent staging with computed tomography revealed a renal cell carcinoma in the left kidney. Synchronous laparoscopic resection of the two carcinomas was performed, with no morbidity. To the best of our knowledge, this is the first report of endolaparoscopic left hemicolectomy and synchronous laparoscopic radical nephrectomy for obstructive carcinoma of the descending colon and renal cell carcinoma. The advantages of colorectal SEMS and the endolaparoscopic approach in managing obstructive colorectal carcinoma are discussed.
authors.affiliation: Department of Surgery, Chinese University of Hong Kong, Prince of Wales Hospital, Satin, Hong Kong SAR, China. simonng@surgery.cuhk.edu.hk
authors.forename: Simon S M
authors.initials: SS
authors.lastname: Ng
authors.forename: Raymond Y C
authors.initials: RY
authors.lastname: Yiu
authors.forename: Jimmy C M
authors.initials: JC
authors.lastname: Li
authors.forename: Chi Kwok
authors.initials: CK
authors.lastname: Chan
authors.forename: Chi Fai
authors.initials: CF
authors.lastname: Ng
authors.forename: James Y W
authors.initials: JY
authors.lastname: Lau
mesh_terms: D000369:Aged, 80 and over; D002292:Carcinoma, Renal Cell / Q000150:complications*; D003082:Colectomy / Q000379:methods*; D003110:Colonic Neoplasms / Q000150:complications*; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology / Q000601:surgery; D007680:Kidney Neoplasms / Q000150:complications*; D010535:Laparoscopy; D008297:Male; D009378:Neoplasms, Multiple Primary / Q000601:surgery*; D009392:Nephrectomy / Q000379:methods*