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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.
References
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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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