Kosin Med J.  2015 Dec;30(2):115-121. 10.7180/kmj.2015.30.2.115.

Simultaneous Laparoscopy-Assisted Resection for Synchronous Colorectal and Gastric Cancer

• Lee SH
• Ahn BK
• Baek SU

• KMID: 2150497
• DOI: http://doi.org/10.7180/kmj.2015.30.2.115

Abstract

OBJECTIVES
The purpose of this study is to evaluate feasibility and safety of simultaneous laparoscopy-assisted resection for synchronous colorectal and gastric cancer.
METHODS
From January 2001 to December 2013, a total of 29 patients underwent simultaneous resection for synchronous colorectal and gastric cancers. Medical records were reviewed, retrospectively.
RESULTS
Eight patients (5 male) underwent laparoscopy-assisted resection (LAP group) and twenty one patients (17 male) underwent open surgery (Open group). In the both group, the mean age (65.2 vs. 63.7 years, p =0.481), body mass index (22.6 vs. 22.3, p = 0.896) was comparable, respectively. In LAP group, laparoscopy-assisted distal gastrectomy was performed for all eight 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 (3.0 vs. 4.6 days p = 0.106), postoperative hospital stay was shorter (12.0 vs. 18.3 days, p = 0.245) in LAP group. The postoperative complications were an ileus, a wound seroma and a bile leakage in LAP group, pneumonia (10.0%), wound bleeding (5.0%) and leakage (5.0%) in Open group.
CONCLUSIONS
The simultaneous laparoscopy-assisted resection for synchronous colorectal cancer and gastric cancer is a feasible and safe procedure.

Keyword

Colorectal cancer; Gastric cancer; Laparoscopic surgery; Synchronous

MeSH Terms

Bile
Body Mass Index
Colorectal Neoplasms
Gastrectomy
Gastroenterostomy
Hemorrhage
Humans
Ileus
Laparoscopy
Length of Stay
Medical Records
Pneumonia
Postoperative Complications
Retrospective Studies
Seroma
Stomach Neoplasms*
Wounds and Injuries

Reference

References

1. The Clinical Outcomes of Surgical Therapy Study Group. A comparison of laparoscopically assisted and open colectomy for colon cancer. N Engl J Med. 2004; 350:2050–9.

2. Veldkamp R, Kuhry E, Hop WC, Jeekel J, Kazemier G, Bonjer HJ, et al. Colon cancer Laparoscopic or Open Resection Study Group (COLOR). Laparoscopic surgery versus open surgery for colon cancer: short-term outcomes of a randomized trial. Lancet Oncol. 2005; 6:477 –84.

3. Guillou PJ, Quirke P, Thorpe H, Walker J, Jayne DG, Smith AM, et al. MRC CLASICC Trial Group. Short-term endpoints of conventional versus laparoscopicassisted surgery in patients with colorectal cancer (MRC CLASICC trial): multicentre, randomised controlled trial. Lancet. 2005; 365:1718–26.

4. Kitano S, Iso Y, Moriyama M, Sugimachi K. Laparoscopy-assisted Billroth I gastrectomy. Surg Laparosc Endosc. 1994; 4:146–48.

5. Kim HH, Hyung WJ, Cho GS, Kim MC, Han SU, Kim W, et al. Morbidity and mortality of laparoscopic gastrectomy versus open gastrectomy for gastric cancer: an interim report—a phase III multicenter, prospective, randomized trial (KLASS Trial). Ann Surg. 2010; 251:417 –20.

6. Pak KH, Hyung WJ, Son T, Obama K, Woo Y, Kim HI, et al. Long-term oncologic outcomes of 714 consecutive laparoscopic gastrectomies for gastric cancer: results from the 7-year experience of a single institute. Surg Endosc. 2012; 26:130–6.

7. Yoo HM, Lee HH, Shim JH, Jeon HM, Park CH, Kim JG, et al. Long-term outcomes and survival after laparoscopy-assisted distal gastrectomy for gastric cancer: three-year survival analysis of a single-center experience in Korea. J Surg Oncol. 2011; 104:511–5.

8. Ikeguchi M, Ohfuji S, Oka A, Tsujitani S, Maeda M, Kaibara N. Synchronous and metachronous primary malignancies in organs other than the stomach in patients with early gastric cancer. Hepatogastroenterology. 1995; 42:672–6.

9. Lee JH, Bae JS, Ryu KW, Lee JS, Park SR, Kim CG, et al. Gastric cancer patients at high-risk of having synchronous cancer. World J Gastroenterol. 2006; 12:2588–92.

10. Saito S, Hosoya Y, Togashi K, Kurashina K, Haruta H, Hyodo M, et al. Prevalence of synchronous colorectal neoplasms detected by colonoscopy in patients with gastric cancer. Surg Today. 2008; 38:20–5.

11. Zhu QL, Zheng MH, Feng B, Lu AG, Wang ML, Li JW, et al. Simultaneous laparoscopy-assisted low anterior resection and distal gastrectomy for synchronous carcinoma of rectum and stomach. World J Gastroenterol. 2008; 14:3435–7.

12. Matsui H, Okamoto Y, Ishii A, Ishizu K, Kondoh Y, Igarashi N, et al. Laparoscopy-assisted combined resection for synchronous gastric and colorectal cancer: report of three cases. Surg Today. 2009; 39:434–9.

13. Ueno M, Muto T, Oya M, Ota H, Azekura K, Yamaguchi T. Multiple primary cancer: an experience at the Cancer Institute Hospital with special reference to colorectal cancer. Int J Clin Oncol. 2003; 8:162–7.

14. Lee SH, Ahn BK, Baek SU. Multiple primary cancers in extracolonic sites with colorectal cancer. Int J Colorectal Dis. 2009; 24:301–4.

15. Lee WS, Lee JN, Choi ST, Jung M, Baek JH, Lee WK. Multiple primary malignancies involving colorectal cancer-clinical characteristics and prognosis with reference to surveillance. Langenbecks Arch Sur. 2010; 395:359–64.

16. Tokunaga M, Hiki N, Fukunaga T, Kuroyanagi H, Miki A, Akiyoshi T, et al. Laparoscopic surgery for synchronous gastric and colorectal cancer: a preliminary experience. Langenbecks Arch Surg. 2010; 395:207–10.

17. Lee J, Nam Y, Kim W. Simultaneous laparoscopy-assisted distal gastrectomy and right hemicolectomy for synchronous advanced gastric and colon cancer. Surg Laparosc Endosc Percutan Tech. 2010; 20:257–61.

18. Nishikawa M, Higashino M, Tanimura S, Fukunaga Y, Tokuhara T. Three cases of synchronous laparoscopic resection for gastric and colonic cancer. Surg Laparosc Endosc Percutan Tech. 2010; 20:e218–25.

19. Hanai T, Uyama I, Sato H, Masumori K, Katsuno H, Ito M, et al. Laparoscopic Assisted Synchronous Gastrectomy and Colectomy with Lymphadenectomy for Double Cancer in our Experience. Hepatogastroenterology. 2012; 59:2177–81.

20. Tagaya N, Kasama K, Suzuki N, Taketsuka S, Horie K, Kubota K. Simultaneous laparoscopic treatment for diseases of the gallbladder, stomach, and colon. Surg Laparosc Endosc Percutan Tech. 2005; 15:169–71.