J Gastric Cancer.  2015 Dec;15(4):286-289. 10.5230/jgc.2015.15.4.286.

Entirely Laparoscopic Gastrectomy and Colectomy for Remnant Gastric Cancer with Gastric Outlet Obstruction and Transverse Colon Invasion

• Kim HI
• Kim MG

• KMID: 2391564
• DOI: http://doi.org/10.5230/jgc.2015.15.4.286

Abstract

It is well known that gastrectomy with curative intent is the best way to improve outcomes of patients with remnant gastric cancer. Recently,several investigators reported their experiences with laparoscopic gastrectomy of remnant gastric cancer. We report the case of an 83-year-old female patient who was diagnosed with remnant gastric cancer with obstruction. She underwent an entirely laparoscopic distal gastrectomy with colectomy because of direct invasion of the transverse colon. The operation time was 200 minutes. There were no postoperative complications. The pathologic stage was T4b (transverse colon) N0M0. Our experience suggests that laparoscopic surgerycould be an effective method to improve the surgical outcomes of remnant gastric cancer patients.

Keyword

Laparoscopy; Gastrectomy; Colectomy; Remnant gastric cancer; Gastric outlet obstruction

MeSH Terms

Aged, 80 and over
Colectomy*
Colon, Transverse*
Female
Gastrectomy*
Gastric Outlet Obstruction*
Humans
Laparoscopy
Postoperative Complications
Research Personnel
Stomach Neoplasms*

Figure

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  Fig. 1 Direct invasion of the efferent loop and transverse colon from remnant gastric cancer.

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  Fig. 2 The extracted specimen showed direct invasion of remnant gastric cancer into efferent loop and transverse colon.

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  Fig. 3 (A) Side-to-side anastomosisof the transverse colon. (B) Closureof anterior hole between the proximaland distal colon. (C) Side-to-sideanastomosis between the remnantstomach and the Roux-en-Y limb. (D)Closure of the anterior hole betweenthe remnant stomach and the Rouxen-Y limb.

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  Fig. 4 Wounds of troca sites pictured in dotted white circles.

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