Synchronous gastric cancer and rectal cancer treated by laparoscopic surgery. EndoTODAY 이준행

[Gastric cancer 891. Synchronous gastric cancer and rectal cancer treated by laparoscopic surgery]

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Laparoscopic surgery for gastric cancer and rectal cancer was done in a single day.

Stomach, radical subtotal gastrectomy: Early gastric carcinoma
1. Location : lower third, Center at antrum and greater curvature
2. Gross type : EGC type IIa
3. Histologic type : tubular adenocarcinoma, moderately differentiated
4. Histologic type by Lauren : intestinal
5. Size : 3.2x3.0 cm
6. Depth of invasion : invades muscularis propria (pT2)
7. Resection margin: free from carcinoma, safety margin: proximal 5.0 cm, distal 6.0 cm
8. Lymph node metastasis : no metastasis in 32 regional lymph nodes (pN0) (0/32: "1", 0/0; "3", 0/8; "4", 0/4; "5", 0/0; "6", 0/4; "7", 0/0; "9", 0/1; "8a", 0/6; "12a", 0/6; "4sb", 0/0; "11p", 0/3)
9. Lymphatic invasion : not identified
10. Venous invasion : not identified
11. Perineural invasion : not identified
12. AJCC stage by 8th edition: pT2 N0
Rectum, low anterior resection: Adenocarcinoma, moderately differentiated
1. Location: rectum
2. Gross type: ulcerofungating
3. Size: 3.2x2.8 cm
4. Depth of invasion: penetrates visceral peritoneum(pT4a)
5. Resection margin: free from carcinoma, safety margin: proximal, 7 cm ; distal, 3 cm ; circumferential(radial), 2 mm
6. Regional lymph node metastasis :
- No metastasis in all 18 regional lymph nodes(pN0) (0/18: "IMA LN", 0/2; perirectal, 0/16)
- Number of Extramural Tumor Deposits: 0
7. Lymphatic invasion: present
8. Venous invasion: not identified
9. Perineural invasion: present(intratumoral)
10. Tumor budding : negative
11. Micropapillary component: yes (10%)
12. Tumor border: infiltrative
13. Pathologic staging: pT4a N0