J Gastric Cancer.  2015 Dec;15(4):286-289. 10.5230/jgc.2015.15.4.286.

Entirely Laparoscopic Gastrectomy and Colectomy for Remnant Gastric Cancer with Gastric Outlet Obstruction and Transverse Colon Invasion

  • 1Department of Surgery, Hanyang University Guri Hospital, Hanyang University College of Medicine, Seoul, Korea. md9650@hanyang.ac.kr


It is well known that gastrectomy with curative intent is the best way to improve outcomes of patients with remnant gastric cancer. Recently,several investigators reported their experiences with laparoscopic gastrectomy of remnant gastric cancer. We report the case of an 83-year-old female patient who was diagnosed with remnant gastric cancer with obstruction. She underwent an entirely laparoscopic distal gastrectomy with colectomy because of direct invasion of the transverse colon. The operation time was 200 minutes. There were no postoperative complications. The pathologic stage was T4b (transverse colon) N0M0. Our experience suggests that laparoscopic surgerycould be an effective method to improve the surgical outcomes of remnant gastric cancer patients.


Laparoscopy; Gastrectomy; Colectomy; Remnant gastric cancer; Gastric outlet obstruction

MeSH Terms

Aged, 80 and over
Colon, Transverse*
Gastric Outlet Obstruction*
Postoperative Complications
Research Personnel
Stomach Neoplasms*


  • Fig. 1 Direct invasion of the efferent loop and transverse colon from remnant gastric cancer.

  • Fig. 2 The extracted specimen showed direct invasion of remnant gastric cancer into efferent loop and transverse colon.

  • Fig. 3 (A) Side-to-side anastomosisof the transverse colon. (B) Closureof anterior hole between the proximaland distal colon. (C) Side-to-sideanastomosis between the remnantstomach and the Roux-en-Y limb. (D)Closure of the anterior hole betweenthe remnant stomach and the Rouxen-Y limb.

  • Fig. 4 Wounds of troca sites pictured in dotted white circles.

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1. Ohashi M, Katai H, Fukagawa T, Gotoda T, Sano T, Sasako M. Cancer of the gastric stump following distal gastrectomy for cancer. Br J Surg. 2007; 94:92–95.
2. Pointner R, Schwab G, Königsrainer A, Bodner E, Schmid KW. Early cancer of the gastric remnant. Gut. 1988; 29:298–301.
3. Thorban S, Böttcher K, Etter M, Roder JD, Busch R, Siewert JR. Prognostic factors in gastric stump carcinoma. Ann Surg. 2000; 231:188–194.
4. Kwon IG, Cho I, Guner A, Choi YY, Shin HB, Kim HI, et al. Minimally invasive surgery for remnant gastric cancer: a comparison with open surgery. Surg Endosc. 2014; 28:2452–2458.
5. Nagai E, Nakata K, Ohuchida K, Miyasaka Y, Shimizu S, Tanaka M. Laparoscopic total gastrectomy for remnant gastric cancer: feasibility study. Surg Endosc. 2014; 28:289–296.
6. Smith RE Jr. The clinical and economic burden of anemia. Am J Manag Care. 2010; 16:Suppl Issues. S59–S66.
7. Detsky AS, Baker JP, O'Rourke K, Johnston N, Whitwell J, Mendelson RA, et al. Predicting nutrition-associated complications for patients undergoing gastrointestinal surgery. JPEN J Parenter Enteral Nutr. 1987; 11:440–446.
8. Fujita J, Kurokawa Y, Sugimoto T, Miyashiro I, Iijima S, Kimura Y, et al. Survival benefit of bursectomy in patients with resectable gastric cancer: interim analysis results of a randomized controlled trial. Gastric Cancer. 2012; 15:42–48.
9. Russell MC, Mansfield PF. Surgical approaches to gastric cancer. J Surg Oncol. 2013; 107:250–258.
10. Kim MG, Kawada H, Kim BS, Kim TH, Kim KC, Yook JH, et al. A totally laparoscopic distal gastrectomy with gastroduodenostomy (TLDG) for improvement of the early surgical outcomes in high BMI patients. Surg Endosc. 2011; 25:1076–1082.
11. Kim MG. Laparoscopic surgery for perforated duodenal ulcer disease: analysis of 70 consecutive cases from a single surgeon. Surg Laparosc Endosc Percutan Tech. 2015; 25:331–336.
12. Guo J, Liang Z, Zhang H, Yang C, Pu J, Mei H, et al. Laparoscopic versus open orchiopexy for non-palpable undescended testes in children: a systemic review and meta-analysis. Pediatr Surg Int. 2011; 27:943–952.
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