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.
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Keywords: Colorectal cancer; Gastric cancer; Laparoscopic surgery; Synchronous
Table 1.Characteristics of synchronous colorectal and gastric cancers
|
LAP group (n=8) |
Open group (n=21) |
P value |
Age (year)∗
|
65.2 |
63.7 |
0.481 |
|
(49–80) |
(47–76) |
|
Sex |
|
|
0.357 |
Male |
5 (62.5) |
17 (81.0) |
|
Female |
3 (37.5) |
4 (19.0) |
|
ASA score (>2) |
5 (62.5) |
18 (85.7) |
0.063 |
Body mass index (kg/m2)∗
|
22.6 |
22.3 |
0.896 |
|
(24.1–24.9) |
(17.3–28.6) |
|
Location of gastric cancers |
|
|
0.664 |
Cardia-fundus |
0 |
2 (9.5) |
|
Body |
5 (62.5) |
12 (57.1) |
|
Antrum, pylorus |
3 (37.5) |
7 (33.3) |
|
Location of colorectal cancers |
|
|
0.428 |
Ascending colon |
2 (25.0) |
4 (19.0) |
|
Transverse colon |
– |
1 (4.8) |
|
Descending colon |
– |
1 (4.8) |
|
Sigmoid colon |
4 (50.0) |
4 (19.0) |
|
Rectum |
2 (25.0) |
11 (52.4) |
|
Table 2.Operation methods for synchronous colorectal and gastric cancers
|
LAP group (n=8) |
Open group (n=21) |
Surgery for colorectal cancers |
|
|
Right hemicolectomy |
1 |
4 (20.0) |
Transverse colectomy |
0 |
1 (4.8) |
Left hemicolectomy |
0 |
1 (4.8) |
AR and LAR∗
|
6 |
13 (65.0) |
Abdominoperineal resection |
0 |
2 (9.5) |
Subtotal colectomy†
|
1 |
0 |
Surgery for gastric cancers |
|
|
Distal gastrectomy |
8 |
0 |
Subtotal gastrectomy |
0 |
15 (71.4) |
Total gastrectomy |
0 |
3 (14.3) |
Wedge resection |
0 |
3 (14.3) |
Table 3.Outcomes of simultaneous resection for colorectal and gastric cancer
|
LAP group (n=8) |
Open group (n=21) |
P value |
Operation time (min) |
281.9 |
312.6 |
0.407 |
|
(200 – 350) |
(205 – 465) |
|
Blood loss (cc) |
281.3 |
467.5 |
0.648 |
|
(50–500) |
(200–700) |
|
Gas out (day) |
3.0 |
4.6 |
0.106 |
|
(1–4) |
(1–9) |
|
Hospital stay (day) |
12.0 |
18.3 |
0.245 |
|
(7–18) |
(9–80) |
|
Complications |
3 (37.5%)∗
|
5 (23.8%)†
|
0.646 |
Lymph node sampling |
|
|
|
Colorectal cancers |
22.56 |
11.78 |
|
|
(10–58) |
(0–39) |
|
Gastric cancers |
30.78 |
22.16 |
|
|
(11–42) |
(3–54) |
|
Stage of Colorectal/Gastric Cancer |
|
|
|
0 |
– |
1 / 0 |
|
1 |
2 / 7 |
3 / 10 |
|
2 |
2 / 1 |
6 / 2 |
|
3 |
4 / 0 |
10 / 5 |
|
4 |
– |
1 / 1 |
|
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