One-Time Combined Surgery by MDT Teams From Shanghai General Hospital Successfully Removed Dual Primary Cancer

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How to perform surgery when a patient diagnosed with gastric cancer and kidney cancer at same time? On January 4th, the Gastroenterology Department of the General Surgery Center of Shanghai General Hospital, together with the Urology Department, Anesthesiology Department, and Operating Room Nursing Team, successfully completed a simultaneous laparoscopic radical gastrectomy and local left nephrectomy for a patient. Both surgeries were performed in a minimally invasive manner and completed within one anesthesia. The patient has successfully recovered and been discharged from the hospital.

Mr. Zhang, 60 years old from Zhejiang, was diagnosed with gastric cancer locally. Preoperative CT evaluation revealed a suspected cancerous mass in his left kidney. Subsequently, the patient came to Shanghai General Hospital for treatment.

Is it one of the cancers that has metastasized, or the patient's stomach and kidney both have primary tumors? Dr. Huang Chen, Director of Gastrointestinal Surgery (North) at the General Surgery Center, and Dr. Zhang Renchao, Deputy Chief Physicians, working with Dr. Wang Xiang, Director of Urology and Oncology at the Urology Center, and experts from multiple departments such as Radiology, Oncology, and Anesthesiology, conducted a multidisciplinary joint consultation and concluded that the patient's clinical data fully suggests primary gastric and renal cancer, rather than metastatic cancer. This phenomenon of having two or more primary cancers at the same time is called dual origin cancer or multiple origin cancer.

To ensure Mr. Zhang's recovery and quality of life, the expert team has decided to perform minimally invasive surgery using laparoscopy, with a joint resection of gastric and left kidney tumors by gastroenterology and urology departments.

On the day of the surgery, Dr. Zhang Renchao performed a total laparoscopic radical gastrectomy on Mr. Zhang. After one and a half hours of close cooperation, the surgical team removed gastric cancer specimens and sent them to the margins for qualitative analysis. While waiting for the intraoperative frozen section pathology report, Wang Xiang's team performed a laparoscopic left kidney local resection for Mr. Zhang through an abdominal approach. After 40 minutes of careful dissection, the surgical team successfully removed the left kidney tumor. After confirming that the gastric margin was negative, the surgical team completed gastrointestinal reconstruction under laparoscopy.

The entire combined surgery lasted for 4 hours, and the surgical team successfully completed a curative surgery for patients with dual primary tumors through 5 small incisions in the abdomen. The total intraoperative bleeding was only 150 milliliters. The patient did not have a gastric tube left and returned to the ward safely.

With the multiple guarantees of the surgical team, the patient's postoperative recovery is smooth. On the second day after surgery, start eating clear liquid food. Three days after surgery, the patient was able to move to the ground and all indicators were normal. On the 10th day after surgery, the patient was discharged smoothly and returned home. At present, the patient can eat normally and has recovered well. They have started receiving postoperative adjuvant chemotherapy and immunotherapy.