Laparoscopic surgery in elderly colorectal cancer patients with a poor performance status is safe and not inferior to open surgery in terms of overall survival.
The patient was a 69-year-old man who presented with a 6-month history of persistent abdominal pain and vomiting. Abdominal CT indicated an obstruction in the small intestine. Following decompression with ileus tube, laparoscopy was performed immediately under the suspicion of internal hernia. The examination revealed that the obstruction was due to a tumor arising from the serosa of the jejunum, 30 cm from the ligament of Treitz. The resection of the jejunum was extended to the mesenterium. Histopathological examination of the resected specimen revealed the diagnosis of well-differentiated adeocarcinoma, with an invasion depth of se, n0, and histological stage II disease. In general, primary cancer of the small intestine is a relatively rare disease and the presenting symptom is variable. Consequently, the most suitable preoperative diagnostic method and the treatment are still undetermined. This is the report of a case in which the low-invasive laparoscopy was shown to be advantageous to diagnose and treat primary cancer of the small intestine.
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