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

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