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

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

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.