Top

Published in:

01-03-2010 | Original article

Laparoscopic surgery for synchronous gastric and colorectal cancer: a preliminary experience

Authors: Masanori Tokunaga, Naoki Hiki, Tetsu Fukunaga, Hiroya Kuroyanagi, Akira Miki, Takashi Akiyoshi, Toshiharu Yamaguchi

Published in: Langenbeck's Archives of Surgery | Issue 3/2010

Abstract

Background

Increasingly, laparoscopy-assisted gastrectomy and laparoscopy-assisted colorectal surgery are being performed. However, simultaneous laparoscopic surgery for synchronous gastric and colorectal cancer is rare and its feasibility unknown.

Method

Early surgical outcomes, including operation time, intraoperative bleeding, postoperative morbidity, mortality, and the duration of the postoperative hospital stay, were investigated in seven consecutive patients who underwent simultaneous laparoscopy-assisted gastrectomy and colorectal surgery at the Cancer Institute Hospital between 2005 and 2008 to clarify the feasibility of simultaneous laparoscopic surgery.

Results

Mean operation time was 392 min and estimated blood loss was 90 mg in patients undergoing simultaneous laparoscopic surgery. Although postoperative morbidity was observed in three patients (surgical site infection, gastric fullness, and enteritis), they recovered well, and the duration of postoperative hospital stay was 19.6 ± 14.1 days. There was no postoperative mortality. Intraoperative complication which required conversion to open surgery was also not found in any of the patients. A small incision measuring 5–6 cm in length was sufficient for both retrieval of resected specimen and enteric anastomosis in all patients.

Conclusions

The laparoscopic approach is a feasible procedure for synchronous gastric and colorectal cancer, provided that the operation is performed by experienced surgeons.

Saito S, Hosoya Y, Togashi K, Kurashina K, Haruta H, Hyodo M, Koinuma K, Horie H, Yasuda Y, Nagai H (2008) Prevalence of synchronous colorectal neoplasms detected by colonoscopy in patients with gastric cancer. Surg Today 38:20–25CrossRefPubMed

Ikeguchi M, Ohfuji S, Oka A, Tsujitani S, Maeda M, Kaibara N (1995) Synchronous and metachronous primary malignancies in organs other than the stomach in patients with early gastric cancer. Hepatogastroenterology 42:672–676PubMed

Lee JH, Bae JS, Ryu KW, Lee JS, Park SR, Kim CG, Kook MC, Choi IJ, Kim YW, Park JG, Bae JM (2006) Gastric cancer patients at high-risk of having synchronous cancer. World J Gastroenterol 12:2588–2592PubMed

Nakajima T (2002) Gastric cancer treatment guidelines in Japan. Gastric Cancer 5:1–5CrossRefPubMed

Maruyama K, Okabayashi K, Kinoshita T (1987) Progress in gastric cancer surgery in Japan and its limits of radicality. World J Surg 11:418–425CrossRefPubMed

Guillou PJ, Quirke P, Thorpe H, Walker J, Jayne DG, Smith AM, Heath RM, Brown JM (2005) Short-term endpoints of conventional versus laparoscopic-assisted surgery in patients with colorectal cancer (MRC CLASICC trial): multicentre, randomised controlled trial. Lancet 365:1718–1726CrossRefPubMed

Shiraishi N, Yasuda K, Kitano S (2006) Laparoscopic gastrectomy with lymph node dissection for gastric cancer. Gastric Cancer 9:167–176CrossRefPubMed

Kitano S, Shiraishi N, Fujii K, Yasuda K, Inomata M, Adachi Y (2002) A randomized controlled trial comparing open vs laparoscopy-assisted distal gastrectomy for the treatment of early gastric cancer: an interim report. Surgery 131(1 Suppl):S306–311CrossRefPubMed

Lee SI, Choi YS, Park DJ, Kim HH, Yang HK, Kim MC (2006) Comparative study of laparoscopy-assisted distal gastrectomy and open distal gastrectomy. J Am Coll Surg 202:874–880CrossRefPubMed

10.

Adachi Y, Shiraishi N, Shiromizu A, Bandoh T, Aramaki M, Kitano S (2000) Laparoscopy-assisted Billroth I gastrectomy compared with conventional open gastrectomy. Arch Surg 135:806–810CrossRefPubMed

11.

Kitano S, Shiraishi N, Uyama I, Sugihara K, Tanigawa N (2007) A multicenter study on oncologic outcome of laparoscopic gastrectomy for early cancer in Japan. Ann Surg 245:68–72CrossRefPubMed

12.

Zhu QL, Zheng MH, Feng B, Lu AG, Wang ML, Li JW, Hu WG, Zang L, Mao ZH, Dong F, Ma JJ, Zong YP (2008) Simultaneous laparoscopy-assisted low anterior resection and distal gastrectomy for synchronous carcinoma of rectum and stomach. World J Gastroenterol 14:3435–3437CrossRefPubMed

13.

Tagaya N, Kasama K, Suzuki N, Taketsuka S, Horie K, Kubota K (2005) Simultaneous laparoscopic treatment for diseases of the gallbladder, stomach, and colon. Surg Laparosc Endosc Percutan Tech 15:169–171CrossRefPubMed

14.

Sobin LH, Wittekind D (eds) (2002) TNM classification of malignant tumors (6th edn)

15.

Kuroyanagi H, Oya M, Ueno M, Fujimoto Y, Yamaguchi T, Muto T (2008) Standardized technique of laparoscopic intracorporeal rectal transection and anastomosis for low anterior resection. Surg Endosc 22:557–561CrossRefPubMed

16.

Tokunaga M, Hiki N, Fukunaga T, Miki A, Nunobe S, Ohyama S, Seto Y, Yamaguchi T (2009) Quality control and educational value of laparoscopy-assisted gastrectomy in a high-volume center. Surg Endosc 23:289–295CrossRefPubMed

17.

Hiki N, Fukunaga T, Yamaguchi T, Nunobe S, Tokunaga M, Ohyama S, Seto Y, Yoshiba H, Nohara K, Inoue H, Muto T (2008) The benefits of standardizing the operative procedure for the assistant in laparoscopy-assisted gastrectomy for gastric cancer. Langenbecks Arch Surg 393:963–971CrossRefPubMed

18.

Hiki N, Shimoyama S, Yamaguchi H, Kubota K, Kaminishi M (2006) Laparoscopy-assisted pylorus-preserving gastrectomy with quality controlled lymph node dissection in gastric cancer operation. J Am Coll Surg 203:162–169CrossRefPubMed

19.

Nunobe S, Hiki N, Fukunaga T, Tokunaga M, Ohyama S, Seto Y, Yamaguchi T (2007) Laparoscopy-assisted pylorus-preserving gastrectomy: preservation of vagus nerve and infrapyloric blood flow induces less stasis. World J Surg 31:2335–2340CrossRefPubMed

20.

Tokunaga M, Hiki N, Fukunaga T, Miki A, Ohyama S, Seto Y, Yamaguchi T (2008) Does age matter in the indication for laparoscopy-assisted gastrectomy? J Gastrointest Surg 12:1502–1507CrossRefPubMed

21.

Nguyen NT, Hinojosa MW, Fayad C, Varela E, Konyalian V, Stamos MJ, Wilson SE (2007) Laparoscopic surgery is associated with a lower incidence of venous thromboembolism compared with open surgery. Ann Surg 246:1021–1027CrossRefPubMed

22.

Hiki N, Shimizu N, Yamaguchi H, Imamura K, Kami K, Kubota K, Kaminishi M (2006) Manipulation of the small intestine as a cause of the increased inflammatory response after open compared with laparoscopic surgery. Br J Surg 93:195–204CrossRefPubMed

Title: Laparoscopic surgery for synchronous gastric and colorectal cancer: a preliminary experience
Authors: Masanori Tokunaga
Naoki Hiki
Tetsu Fukunaga
Hiroya Kuroyanagi
Akira Miki
Takashi Akiyoshi
Toshiharu Yamaguchi
Publication date: 01-03-2010
Publisher: Springer-Verlag
Published in: Langenbeck's Archives of Surgery / Issue 3/2010
Print ISSN: 1435-2443
Electronic ISSN: 1435-2451
DOI: https://doi.org/10.1007/s00423-009-0514-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Laparoscopic surgery for synchronous gastric and colorectal cancer: a preliminary experience

Abstract

Background

Method

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Method

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 3/2010

Does internal stenting of the pancreaticojejunostomy improve outcomes after pancreatoduodenectomy? A prospective study

Laparoscopic cholecystectomy—comparison of early postoperative results in an Australian rural centre and a German university hospital

Clinicopathological features of anastomotic recurrence after an anterior resection for rectal cancer

Pure red cell aplasia regression after thymus resection

Impact of difference in the definition of extranodal spread on the outcome of node-positive patients with gastric cancer

Postoperative hemorrhagic complications after elective laparoscopic cholecystectomy in patients receiving long-term anticoagulant therapy