Laparoscopic subtotal proctocolectomy for synchronous triple colorectal cancers: a case report

Area of Science:

• Gastroenterology
• Surgical Oncology

Background:

• Synchronous multiple colorectal cancers present a complex diagnostic and therapeutic challenge.
• Early detection and appropriate management are crucial for improving patient outcomes.

Observation:

• A 42-year-old woman presented with abdominal pain and was diagnosed with advanced transverse colon cancer causing bowel obstruction.
• Colonoscopy revealed three distinct lesions: an advanced transverse colon tumor, a laterally spreading descending colon tumor, and a rectal polyp, all diagnosed as adenocarcinoma.
• Initial management included stent placement for decompression and endoscopic submucosal dissection for the descending colon tumor.

Findings:

• Pathological examination confirmed submucosal invasion and positive margins for the descending colon tumor.
• The rectal polyp also showed submucosal invasion.
• Laparoscopic subtotal proctocolectomy with ileorectal anastomosis and comprehensive lymph node dissection was performed.

Implications:

• This case underscores the feasibility of laparoscopic subtotal proctocolectomy in managing synchronous multiple colorectal cancers.
• The successful surgical intervention and uneventful postoperative course suggest this approach can be effective in selected patients.
• Further research and case reports are needed to establish standardized treatment guidelines for such complex presentations.