title: Laparoscopic assisted synchronous gastrectomy and colectomy with lymphadenectomy for double cancer in our experience.
abstract: Laparoscopic gastrointestinal surgery with lymphadenectomy is rarely performed for multiple gastrointestinal cancers. We report four patients undergoing laparoscopic surgery for synchronous cancer of the stomach and colon. Resection of each organ with lymphadenectomy was performed by each specialist and the region of the lymphadenectomy was determined according to the lesion of cancer and its depth. The selection of gastric anastomosis, whether intracorporeal or extracorporeal, depended on the resecting areas of the large bowel to allow a small incision. All four cases were male with the median age of 69 (range 59-77) years. The median number of trocars used were 6 (range 5-8) and median length of incision was 4.5 cm (range 4-4.5 cm). The median operative time and blood loss were 495.5 minutes (range 390-605) and 88 g (range 36-245), respectively. In all four cases, laparoscopic surgery with a lymphadenectomy on each region was successfully accomplished according to the respective progression stage. Anastomosis was completed with a small incision by using techniques and devices to provide a variation of anastomosis methods and incision positions. Laparoscopic surgery with lymphadenectomy was also undertaken for a patient with gastric remnant cancer and colorectal cancer. The median length of the postoperative hospital stay was 14.5 days (range 12-29). No complications were observed after the surgery. There was no case of recurrence during a median follow-up of 84.3 months (range 54.9-111.5). Laparoscopic surgery was feasible for patients with double cancer of the stomach and colon.
authors.affiliation: Department of Surgery, Fujita Health University School of Medicine, Aichi, Japan. kouichi@fujita-hu.ac.jp
authors.forename: Tsunekazu
authors.initials: T
authors.lastname: Hanai
authors.forename: Ichiro
authors.initials: I
authors.lastname: Uyama
authors.forename: Harunibu
authors.initials: H
authors.lastname: Sato
authors.forename: Kouji
authors.initials: K
authors.lastname: Masumori
authors.forename: Hidetoshi
authors.initials: H
authors.lastname: Katsuno
authors.forename: Masahiro
authors.initials: M
authors.lastname: Ito
authors.forename: Koutaro
authors.initials: K
authors.lastname: Maeda
mesh_terms: D000368:Aged; D000714:Anastomosis, Surgical; D016063:Blood Loss, Surgical; D003082:Colectomy / Q000379:methods*; D003110:Colonic Neoplasms / Q000473:pathology / Q000601:surgery*; D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy; D007902:Length of Stay; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary; D010348:Patient Care Team; D013274:Stomach Neoplasms / Q000473:pathology* / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome