A Case of Transverse Colon Cancer Resected by Laparoscopic Extended Right Hemicolectomy with Intracorporeal Anastomosis, After Open Total Gastrectomy.

A 72-year-old woman was found by colonoscopy to have transverse colon cancer. She had a history of open total gastrectomy with ante-colic Roux-en-Y reconstruction for gastric cancer. We performed a laparoscopic extended right hemicolectomy. Intraoperatively, the tumor was located on the right-sided transverse colon. In order to keep a sufficient distal margin, it was necessary to release adhesions between the reconstructed jejunum and the left-sided transverse colon and mobilize the splenic flexure, while it was necessary to redo the esophago-jejunostomy if ischemic changes were caused by damage to the blood vessels of the reconstructed jejunum. Although we did not keep a sufficient distal margin, we planned to resect the transverse colon located 5 cm on the anal side from the tumor and perform intracorporeal anastomosis, which was end-to-end anastomosis between the ileum and the transverse colon using liner staplers. She was discharged without complications on the 11th postoperative day. Intracorporeal anastomosis has the advantage of requiring minimal mobilization of the colon. In cases of transverse colon cancer after total gastrectomy, we consider that intracorporeal anastomosis is one of the treatment options. [ABSTRACT FROM AUTHOR]