[A case of repeated postoperative recurrence of gastric cancer treated via laparoscopic approach]

A 74-year-old man who had undergone distal gastrectomy was diagnosed with metastasis to the spleen and transverse colon 27 months after the operation, and 6 courses of combination therapy with S-1 and cisplatin (CDDP) were administered. However, both lesions showed progressive disease (PD) after chemotherapy. Massive gastrointestinal hemorrhage from colon metastases was observed following the administration of irinotecan(CPT-11). Therefore, total remnant gastrectomy, splenectomy, and partial transverse colectomy were performed via the laparoscopic approach. Chemotherapy using paclitaxe(l PTX) was initiated after surgery. However, bowel obstruction due to intestinal metastatic lesions developed after 4 courses of PTX therapy, and right hemicolectomy and partial resection of the small intestine were performed laparoscopically. Although combination therapy of capecitabine and CDDP were administered, the patient died 28 months after the diagnosis of recurrent disease. Typically, surgical intervention is rarely effective in cases of recurrent disease from gastric cancer. However, a favorable quality of life was obtained in the case of our patient with aggressive multimodal therapy that included laparoscopic surgery.