Simultaneous Laparoscopic Treatment of Gastric and Rectal Cancers in a 92-year-old Man View PDF

^*Nobumi Tagaya
Department Of Surgery, Dokkyo Medical University Koshigaya Hospital, Koshigaya , Japan

^*Corresponding Author:

Nobumi Tagaya
Department Of Surgery, Dokkyo Medical University Koshigaya Hospital, Koshigaya , Japan
Email:tagaya@dokkyomed.ac.jp

Published on: 2015-03-15

Abstract

We report a successful simultaneous laparoscopic treatment for gastric and rectal neoplasms in a patient of very advanced age. A 92-year-old man presented with nausea, vomiting and appetite loss. Upper gastrointestinal endoscopy revealed a 5-cm ulcerated tumor in the gastric antrum and colonoscopy demonstrated a protruding tumor more than 3 cm in diameter with a tendency for easy bleeding in the recto-sigmoid colon. Abdominal CT revealed a 53x40-mm abdominal aortic aneurysm extending from just below the branch point of the renal artery to the bifurcation of the common iliac vessels. Physical examinations showed values within the normal ranges for general anesthesia. We considered simultaneous laparoscopic treatment for these lesions, at the request of the patient and his family. The operation was started by placing 5 ports and a 5-cm longitudinal incision, utilizing one of the previous ports, for the stomach lesion, and then adding a 4-cm longitudinal incision for the rectal lesion. The laparoscopic procedures consisted of distal gastrectomy with lymph node dissection and partial resection of the rectum.

Keywords

Simultaneous laparoscopic treatment; Laparoscopic surgery; Distal gastrectomy; Rectal resection

Introduction

Endoscopic surgery has been actively adopted for various applications worldwide. In the field of abdominal surgery in particular, there has been a steadily shift from an open to a laparoscopic approach in order to achieve minimal while achieving similar outcomes and a superior aesthetic result. Furthermore, various limitations of a laparoscopic approach have been overcome, and its indications have been extended to patients of a wide age range and to techniques with various degrees of technical difficulty.