Our Summary

Gastric (stomach) cancer and colon cancer are not very common, but they do occur. In the past, traditional surgery required a large incision to remove the cancer, but now, thanks to advancements in technology, less invasive surgeries are possible.

This paper describes the case of a patient who had both gastric and colon cancer. The patient had been experiencing upper abdominal pain for six months. Tests showed that they had a large ulcer in their stomach and a thickening of the wall of their sigmoid colon (the lower part of the colon). Biopsies confirmed that these were poorly differentiated adenocarcinomas, a type of cancer.

The doctors diagnosed the patient with both gastric and sigmoid colon cancer. They chose to treat the patient with a laparoscopic subtotal gastrectomy and sigmoidectomy combined with natural orifice specimen extraction surgery, which is a minimally invasive procedure that involves removing the cancer through a natural opening in the body, such as the mouth or anus. A year after the surgery, the patient showed no signs of cancer recurrence.

The research concludes that it’s important for doctors to have a good understanding of gastric and sigmoid colon cancer, and to use a combination of examinations and pathology to avoid misdiagnosing these cancers as metastatic (spread to other parts of the body) cancer. It also suggests that less invasive surgeries can be a good option for some patients.

FAQs

  1. What are some of the symptoms of gastric and sigmoid colon cancer?
  2. How is a laparoscopic subtotal gastrectomy and sigmoidectomy performed?
  3. What are the benefits of less invasive surgeries for cancer treatment?

Doctor’s Tip

A helpful tip a doctor might give a patient about sigmoidectomy is to discuss with their healthcare team about the possibility of less invasive surgeries, such as laparoscopic or robotic-assisted procedures, which can result in shorter recovery times, less pain, and smaller incisions. It’s important to have open communication with your healthcare team and ask any questions you may have about the procedure and your treatment plan.

Suitable For

Patients who are typically recommended sigmoidectomy are those with conditions such as:

  1. Colon cancer: Sigmoidectomy may be recommended for patients with colon cancer located in the sigmoid colon, which is the S-shaped part of the colon located near the rectum.

  2. Diverticulitis: Sigmoidectomy may be recommended for patients with severe diverticulitis, a condition in which small pouches in the colon become inflamed or infected.

  3. Crohn’s disease: Sigmoidectomy may be recommended for patients with severe Crohn’s disease affecting the sigmoid colon.

  4. Ulcerative colitis: Sigmoidectomy may be recommended for patients with severe ulcerative colitis that is not responsive to other treatments.

  5. Chronic constipation: Sigmoidectomy may be recommended for patients with chronic constipation caused by a redundant or elongated sigmoid colon.

  6. Sigmoid volvulus: Sigmoidectomy may be recommended for patients with a twisted or obstructed sigmoid colon, known as sigmoid volvulus.

  7. Sigmoid polyps: Sigmoidectomy may be recommended for patients with large or precancerous polyps in the sigmoid colon.

Overall, patients who are recommended sigmoidectomy are those with conditions that require the removal of part or all of the sigmoid colon to treat the underlying disease or prevent complications. It is important for patients to discuss their specific condition and treatment options with their healthcare provider to determine if sigmoidectomy is the best course of action for them.

Timeline

  • Six months before surgery: Patient experiences upper abdominal pain and undergoes tests that reveal a large ulcer in the stomach and thickening of the sigmoid colon wall, which are confirmed to be poorly differentiated adenocarcinomas.
  • Day of surgery: Patient undergoes laparoscopic subtotal gastrectomy and sigmoidectomy combined with natural orifice specimen extraction surgery to remove the gastric and colon cancer.
  • One year after surgery: Patient shows no signs of cancer recurrence.
  • Ongoing follow-up: Patient continues to be monitored for any signs of cancer recurrence and receives necessary treatments or interventions as needed.

What to Ask Your Doctor

Some questions a patient should ask their doctor about sigmoidectomy for gastric and colon cancer include:

  1. What are the risks and benefits of undergoing a laparoscopic subtotal gastrectomy and sigmoidectomy for my gastric and colon cancer?
  2. How long is the recovery period after this type of surgery, and what can I expect during the recovery process?
  3. Will I need any additional treatments, such as chemotherapy or radiation therapy, after the surgery?
  4. What is the success rate of this type of surgery for treating both gastric and colon cancer?
  5. Are there any potential complications or side effects associated with this surgery that I should be aware of?
  6. How often will I need follow-up appointments or tests to monitor for cancer recurrence after the surgery?
  7. Are there any dietary or lifestyle changes I should make before or after the surgery to improve my outcomes?
  8. Can you explain the natural orifice specimen extraction surgery and why it is being recommended for my case?
  9. How experienced is the surgical team in performing this type of surgery, and what outcomes have they seen in similar cases?
  10. Are there any alternative treatment options available for my gastric and colon cancer, and how do they compare to surgery in terms of effectiveness and recovery time?

Reference

Authors: Zhu Q, Yu L, Zhu G, Jiao X, Li B, Qu J. Journal: Front Surg. 2022 Jun 8;9:907288. doi: 10.3389/fsurg.2022.907288. eCollection 2022. PMID: 35756479