Non-Incisional Laparoscopic Left Nephrectomy With Abdomino-Perineal Resection for Synchronous Primary Tumors

Multiple synchronous neoplasms were first described in a study by Billroth in 1889. Since then, many researches have been conducted in this field till 1932 when Warren and Gates published their criteria for the diagnosis of two synchronous tumors. Synchronous colorectal and renal blastomas are rare. The number of case reports published so far is relatively small.

We report a case of a 63-years old male patient who was admitted to our clinic with symptomatic, histologically confirmed rectal adenocarcinoma located near the anorectal line. Contrast-enhanced CT showed evidence of synchronous lesion in the left kidney area. Laparoscopic left nephrectomy was performed, followed by abdominoperineal resection of the rectum with total mesorectal excision and para-aortic lymph dissection. Both resectates were extracted through the perineal access with no need for additional abdominal incision. No similar case was found in our literature review without using abdominal incision.

The simultaneous multi-visceral laparoscopic resection of synchronous neoplasms is a reliable and safe method in certain patients. When performed by an experienced surgical team, the oncological outcomes are comparable to those achieved; using a conventional approach. A specific advantage is that this is a one-stage surgery that provides quick recovery with lower risk of postoperative complications.