title: Curative two-stage resection for synchronous triple cancers of the esophagus, colon, and liver: Report of a case.
abstract: BACKGROUND
  Cases of synchronous triple cancers of the esophagus and other organs curatively resected are rare.
  
  
  METHODS
  A 73-year-old man was admitted to our hospital with bloody feces. He was diagnosed with synchronous triple cancers of the esophagus, colon, and liver. We selected a two-stage operation to safely achieve curative resection for all three cancers. The first stage of the operation comprised a laparoscopy-assisted sigmoidectomy and partial liver resection via open surgery. The patient was discharged without complications. Thirty days later, he was readmitted and thoracoscopic esophagectomy was performed. Although pneumonia-induced pulmonary aspiration occurred as a postoperative complication, it was treated conservatively. The patient was discharged on postoperative day 24.
  
  
  CONCLUSIONS
  Esophagectomy is a highly invasive procedure; thus, simultaneous surgery for plural organs, including the esophagus, may induce life-threatening, severe complications. Two-stage surgery is useful in reducing surgical stress in high-risk patients. For synchronous multiple cancers, the planning of two-stage surgery should be considered for each cancer to maintain organ function and reduce the stress and difficulty of each stage.
  
  
  CONCLUSIONS
  We successfully treated synchronous triple cancers, including esophageal cancer, by a two-stage operation.
authors.affiliation: Department of Surgery, Department of Palliative Care Medicine, Iwate Medical University School of Medicine, 19-1 Uchimaru, Morioka, Iwate 020-8505, Japan. Electronic address: yakiyama@iwate-med.ac.jp.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Akiyama
authors.affiliation: Department of Surgery, Department of Palliative Care Medicine, Iwate Medical University School of Medicine, 19-1 Uchimaru, Morioka, Iwate 020-8505, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Iwaya
authors.affiliation: Department of Surgery, Department of Palliative Care Medicine, Iwate Medical University School of Medicine, 19-1 Uchimaru, Morioka, Iwate 020-8505, Japan.
authors.forename: Masafumi
authors.initials: M
authors.lastname: Konosu
authors.affiliation: Department of Surgery, Department of Palliative Care Medicine, Iwate Medical University School of Medicine, 19-1 Uchimaru, Morioka, Iwate 020-8505, Japan.
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Shioi
authors.affiliation: Department of Surgery, Department of Palliative Care Medicine, Iwate Medical University School of Medicine, 19-1 Uchimaru, Morioka, Iwate 020-8505, Japan.
authors.forename: Fumitaka
authors.initials: F
authors.lastname: Endo
authors.affiliation: Department of Surgery, Department of Palliative Care Medicine, Iwate Medical University School of Medicine, 19-1 Uchimaru, Morioka, Iwate 020-8505, Japan.
authors.forename: Hirokatsu
authors.initials: H
authors.lastname: Katagiri
authors.affiliation: Department of Surgery, Department of Palliative Care Medicine, Iwate Medical University School of Medicine, 19-1 Uchimaru, Morioka, Iwate 020-8505, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Nitta
authors.affiliation: Department of Surgery, Department of Palliative Care Medicine, Iwate Medical University School of Medicine, 19-1 Uchimaru, Morioka, Iwate 020-8505, Japan.
authors.forename: Toshimoto
authors.initials: T
authors.lastname: Kimura
authors.affiliation: Department of Surgery, Department of Palliative Care Medicine, Iwate Medical University School of Medicine, 19-1 Uchimaru, Morioka, Iwate 020-8505, Japan.
authors.forename: Koki
authors.initials: K
authors.lastname: Otsuka
authors.affiliation: Department of Surgery, Department of Palliative Care Medicine, Iwate Medical University School of Medicine, 19-1 Uchimaru, Morioka, Iwate 020-8505, Japan.
authors.forename: Keisuke
authors.initials: K
authors.lastname: Koeda
authors.affiliation: Department of Surgery, Department of Palliative Care Medicine, Iwate Medical University School of Medicine, 19-1 Uchimaru, Morioka, Iwate 020-8505, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Kashiwaba
authors.affiliation: Department of Surgery, Department of Palliative Care Medicine, Iwate Medical University School of Medicine, 19-1 Uchimaru, Morioka, Iwate 020-8505, Japan.
authors.forename: Masaru
authors.initials: M
authors.lastname: Mizuno
authors.affiliation: Department of Surgery, Department of Palliative Care Medicine, Iwate Medical University School of Medicine, 19-1 Uchimaru, Morioka, Iwate 020-8505, Japan.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Kimura
authors.affiliation: Department of Surgery, Department of Palliative Care Medicine, Iwate Medical University School of Medicine, 19-1 Uchimaru, Morioka, Iwate 020-8505, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Sasaki
keywords: Esophageal cancer; Synchronous triple cancers; Two-stage operation