Laparoscopic sleeve gastrectomy as a bridge to colorectal cancer surgery for obese patients: a case report.

Abstract

Background: Severe obesity greatly influences the difficulty of colorectal cancer surgery and has been reported to prolong operative time, increase the rate of laparotomy, and elevate increase postoperative complications. We investigated the efficacy of laparoscopic sleeve gastrectomy (LSG) for preoperative weight loss to ensure safe colorectal cancer surgery.

Case presentation: A 51 year-old female with a body mass index of 43.5 kg/m² was referred to our hospital due to a positive fecal occult blood test. She was diagnosed as having a laterally spreading tumor of the cecum by colonoscopy. Endoscopic submucosal dissection was attempted but proved difficult due to the size of the lesion and its proximity to the appendiceal orifice. We planned bariatric surgery prior to colorectal surgery, and she underwent LSG without any complications. Seven months after the LSG, she had lost 30.7 kg, and her final preoperative body mass index was 27.8 kg/m². Single-incision laparoscopic ileocecal resection was then performed safely. The pathological diagnosis was adenocarcinoma in adenoma of the cecum, TisN0M0.

Conclusion: LSG was effective in reducing visceral fat and making it possible to perform safe surgery for colorectal cancer in a severely obese patient.