Search

Background: The aim of the study is to analyze the results of laparoscopy in septuagenarians with sigmoid colon or rectal cancer., Methods: Patients who underwent laparoscopic or hand-assisted laparoscopic sigmoid or rectal resections for cancer were retrospectively selected from the database of our institution. The study group (Lap > 70 group), contained the cancer patients over 70 years old who were treated with laparoscopy. Patients less than 70 years old who underwent a laparoscopic procedure (Lap < 70 group), and those over than 70 years old who underwent conventional surgery (Open > 70 group), were assigned to control groups. Demographics, information regarding tumors, perioperative data, pathological results, and survival in the three groups were compared., Results: There were 56, 166, and 34 patients in the Lap > 70, Lap < 70, and Open > 70 groups, respectively. Patients in the Lap > 70 group were significantly older than other groups. The American Society of Anesthesiologists scores were higher, and the presence of the studied risk factors was more common in the Lap > 70 group than the Lap < 70 group. Intraoperative bleeding and the amount and number of perioperative transfusions required were less in the Lap > 70 group than in the Open > 70 group. The number of harvested lymph nodes was less in the Lap > 70 group than both study groups. Five-year survival in the Lap > 70 group was similar to that in the Lap < 70 group and significantly better than in the Open > 70 group., Conclusions: Laparoscopy for sigmoid colon and rectal cancer in patients over 70 may be feasible and safe as it is in younger patients. The present study has revealed that laparoscopy in the elderly may be superior to conventional techniques as regards some intraoperative findings and survival.

Background: The aim of the current study is to compare the results after partial and complete splenic flexure mobilization (SFM)., Subjects and Methods: The records of laparoscopic and hand-assisted laparoscopic procedures for primary rectal tumor patients were abstracted from a prospectively designed database. The phrenicocolic and splenocolic ligaments were divided via a four-trocar technique in the partial SFM group, and dissection was continued with the separation of gastrocolic and pancreaticomesocolic attachments via a five-trocar procedure in the complete SFM group. The following data were compared between the groups: Demographics, intra- and postoperative information, and pathological features., Results: In total, 122 cases (77 [63.1%] male, 58.2±13.2 years old) who underwent a partial (n=36, 29.5%) or a complete (n=86, 70.5%) SFM were included. Reservoir creation (48.8% versus 19.4%, P=.003) was more common and conversion (8.1% versus 22.2%, P=.039) was less frequent in the complete SFM group, but there were significantly more T4 tumors in the partial group (16.7% versus 2.3%, P=.008). Demographics, other intra- and postoperative parameters, and pathological features were identical., Conclusions: In our study, complete SFM decreased conversion rates, but this finding may be related to the higher rate of T4 tumors in the partial SFM group. Complete SFM assures an increase in reservoir creation in patients receiving a low anterior resection. Because other parameters are identical, the decision for the level of SFM is better left to the surgeon in cases undergoing a low anterior resection, but complete SFM may be preferred in cases who are candidates for a reservoir formation.

Background: Laparoscopic abdominoperineal resection (APR) has been seldom studied apart from low anterior resections, and deserves to be separately analyzed. This study aims to compare perioperative and oncological outcomes of laparoscopic and conventional APRs performed for the treatment of mid and low rectal adenocarcinomas., Materials and Methods: Patients operated for primary mid or low rectal adenocarcinoma between 2001 and 2009 in our institution were retrospectively investigated. These data were abstracted and compared within conventional and laparoscopic resection groups: demographics, tumor and procedure-related parameters, perioperative results, early oncological outcomes, and survival., Results: Demographics and tumor and procedure-related parameters were similar within the laparoscopic (n=31) and conventional (n=36) groups, except intraoperative bleeding and requirement for transfusion, which were significantly lower after laparoscopic APRs. Perioperative results including complication, reoperation, and 30-day mortality rates were identical. Early oncological results and 3-year survival rates were alike., Conclusions: The perioperative results and oncological outcomes are similar after laparoscopic and conventional APRs. As current data include limited number of patients in a retrospective design, further studies comparing laparoscopic and conventional APR techniques are required.

In this paper, we discuss a 62-year-old woman who, in the course of 7 years (1994-2001), developed three cancers: adenocarcinoma of the stomach, adenocarcinoma of the cecum, and insular thyroid carcinoma, which metastasized to the retroperitoneal lymph nodes and liver. The patient died from complications related to the metastases. The results of basic genetic tests were normal. To the best of our knowledge, no other patient with the combination of these three cancers has been reported in the literature. Although patients with multiple cancers are not common, it is nonetheless important for clinicians to consider the possibility of second and third cancers in patients who were treated for a primary malignant tumor.