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Original Article
Simultaneous Laparoscopy-Assisted Resection for Synchronous Colorectal and Gastric Cancer
Seung-Hyun Lee, Byung-Kwon Ahn, Sung-Uhn Baek
Kosin Medical Journal 2015;30(2):115-121.
DOI: https://doi.org/10.7180/kmj.2015.30.2.115
Published online: January 20, 2015

Department of Surgery, College of Medicine, Kosin University, Busan, Korea

Corresponding Author: Byung-Kwon Ahn, Department of Surgery, Kosin University College of Medicine, 262, Gamcheon-ro, Seo-gu, Busan 49267, Korea Tel: +82-51-990-6462 Fax: +82-51-246-6093 E-mail: gsabk@hotmail.com
• Received: January 2, 2014   • Accepted: August 5, 2014

Copyright © 2015 Kosin University School of Medicine Proceedings

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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  • 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.
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)  

Values are mean (range); other values in parentheses are percentage

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)

AR and LAR; anterior resection and low anterior resection, † in a patient with family history of colorectal cancers

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  

ileus (1), wound seroma (1), bile leakage (1);

ileus (1), pneumonia (1), anastomotic bleeding (1), anastomotic leakage (1)

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