[Simultaneous Robotic Surgery for Synchronous Multiple Cancers with Gastric Cancers-Three Case Reports].

Synchronous gastric cancer(GC)is rare. We performed simultaneous robotic surgery in 2 cases of colorectal cancer and one case of renal cancer with GC. In case 1(GC cStage Ⅰ, rectal cancer[RC]cStage ⅡB, and descending colon cancer cStage ⅢB), peritoneal dissemination of RC was observed during surgery. Robotic high anterior resection, left hemicolectomy, and D3 lymph node dissection(LND)were performed, followed by distal gastrectomy and D1 LND. The operation time was 600 minutes, with an estimated blood loss of 0 mL. In case 2(GC cStage ⅡA, RC cStage ⅡB), robotic distal gastrectomy, D2 LND, low anterior resection, and D3 LND were performed. The operation time was 648 minutes, with an estimated blood loss of 0 mL. In case 3(right renal cancer cStage Ⅰ, GC 1: cStage ⅡA, and GC 2: cStage ⅡA), a robotic partial right nephrectomy, total gastrectomy, and D2 LND were performed. The operation time was 926 minutes, with an estimated blood loss of 447 mL. Discussion: Although simultaneous surgery for multiple cancers is lengthy and highly invasive, it avoids the risk of tumor growth during the waiting period and adhesion during reoperation. These procedures were performed safely and proved to be beneficial in terms of operating room utilization and cost.

Conclusion

Simultaneous robotic surgery for GC is a viable option for patients with synchronous cancers.