Lee Junhyun, Nam Yuhee, Kim Wook
Division of Gastrointestinal Surgery, Department of Surgery, St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Surg Laparosc Endosc Percutan Tech. 2010 Aug;20(4):257-61. doi: 10.1097/SLE.0b013e3181e368e4.
Concurrent laparoscopic surgery for the synchronous gastric and colon cancer in one patient is not only a rare procedure, but also has some demerits such as longer operation time, more blood loss, and the use of additional laparoscopic ports. Moreover, laparoscopy-assisted distal gastrectomy with extraperigastric lymph node dissection is still controversial in the case of advanced gastric cancer.
We report the successful laparoscopic surgery of a 78-year-old patient with synchronous advanced gastric and right colon cancers. The laparoscopy-assisted distal gastrectomy with extraperigastric lymph node dissection followed by right hemicolectomy through 7 ports was carried out.
All procedures were successfully performed without complications and the patient has had no evidence of recurrence for 33 months after the operation. Synchronous neoplasms that are distantly located from one another could be treated using minimally invasive technique, which may sufficiently relieve patients' postoperative distress in selected cases.
对同一患者同时进行腹腔镜手术治疗同步性胃癌和结肠癌不仅是一种罕见的手术,而且存在一些缺点,如手术时间更长、失血更多以及需要使用额外的腹腔镜端口。此外,对于进展期胃癌,腹腔镜辅助远端胃切除术加胃周外淋巴结清扫仍存在争议。
我们报告了一例78岁同步性进展期胃癌和右结肠癌患者成功接受腹腔镜手术的病例。通过7个端口进行了腹腔镜辅助远端胃切除术加胃周外淋巴结清扫,随后进行了右半结肠切除术。
所有手术均成功完成,无并发症发生,患者术后33个月无复发迹象。相距较远的同步性肿瘤可采用微创技术治疗,在某些特定病例中,这可能充分减轻患者的术后痛苦。