Long-Term Survival after Complete Resection of Local Duodenal Recurrence following Colon Cancer Surgery Using Laparoscopic and Endoscopic Cooperation: A Case Report.
- 1Department of Surgery, Japanese Red Cross Fukuoka Hospital, Fukuoka, Fukuoka, Japan.
- 2Department of Surgery, Kyushu Railway Memorial Hospital, Kitakyushu, Fukuoka, Japan.
Abstract
Introduction
Laparoscopic and endoscopic cooperative surgery (LECS) enables accurate intraluminal localization and limited full-thickness resection while preserving gastrointestinal continuity. Although LECS has been used for selected primary duodenal tumors, its application to a postoperative duodenal recurrence of colorectal cancer has rarely been described. We report a case of localized duodenal recurrence after a right hemicolectomy that was completely resected using laparoscopic and endoscopic cooperation.Case presentation
An 83-year-old man underwent a laparoscopic right hemicolectomy with a D3 lymph node dissection for advanced ascending colon cancer. Histopathological examination demonstrated a microscopically positive dissected margin on the duodenal side, indicating a microscopically positive margin (R1) resection. Nine months later, surveillance upper gastrointestinal endoscopy and contrast-enhanced CT revealed a solitary lesion in the second portion of the duodenum without distant metastasis or radiological pancreatic involvement. Endoscopic ultrasonography showed a lesion extending to the fourth layer. An upper gastrointestinal contrast study was not performed; instead, the location and local extent of the lesion were assessed by upper gastrointestinal endoscopy, endoscopic ultrasonography, and contrast-enhanced CT. Because the multimodal assessment indicated that complete local excision was technically achievable, LECS was performed. Intraoperative endoscopy delineated a wider intraluminal extent than was apparent from the serosal surface and guided an en bloc full-thickness resection. The defect was closed in the short-axis direction by a continuous full-thickness suturing. Intraoperative endoscopy confirmed the luminal patency and a negative leak test. Histopathological examination showed an adenocarcinoma involving the submucosa and muscularis propria without duodenal mucosal involvement. The adjacent muscularis propria was inverted toward the lumen, suggesting inward progression from the outer aspect of the duodenal wall. Together with the previous R1, these findings supported a localized recurrence from microscopic residual disease. The resection margins were negative, and the patient has remained disease-free for more than 5 years.Conclusions
Laparoscopic and endoscopic cooperation enabled precise definition of the recurrent lesion, complete full-thickness local resection, and secure closure while preserving duodenal continuity. This approach may be useful for strictly localized duodenal recurrence when careful preoperative assessment indicates that complete local excision is achievable.
Related
- Lymph Node Recurrence after Endoscopic Resection of Early Gastric Cancer Previously Classified as eCura B
- Endoscopic and Symptomatic Outcomes of Vonoprazan for Erosive Esophagitis Following Laparoscopic Sleeve Gastrectomy: An Exploratory Prospective Study
- Acute visual deterioration following endoscopic transsphenoidal resection of a pituitary adenoma secondary to a de novo cyst of normal pituitary origin: illustrative case
- Endoscopic transorbital approach for resection of Meckel’s cave aspergillosis: illustrative case
- Short-Term Outcomes of Outpatient Endoscopic Resection for Selected Superficial Gastric Neoplasms: A Predominantly EMR-Based Real-World Cohort Study
BibTeX
@article{kameda2026longterm,
title = {{Long-Term Survival after Complete Resection of Local Duodenal Recurrence following Colon Cancer Surgery Using Laparoscopic and Endoscopic Cooperation: A Case Report.}},
author = {Chizu Kameda and Yasunori Oda and Shunichi Takahata and Eishi Nagai and Yuji Nakafusa},
journal = {Surgical case reports},
year = {2026},
month = oct,
doi = {10.70352/scrj.cr.26-0565},
url = {https://europepmc.org/article/MED/42948027},
note = {CC BY},
}
RIS
TY - JOUR
TI - Long-Term Survival after Complete Resection of Local Duodenal Recurrence following Colon Cancer Surgery Using Laparoscopic and Endoscopic Cooperation: A Case Report.
AU - Chizu Kameda
AU - Yasunori Oda
AU - Shunichi Takahata
AU - Eishi Nagai
AU - Yuji Nakafusa
PY - 2026
DA - 2026/10/24
JO - Surgical case reports
DO - 10.70352/scrj.cr.26-0565
UR - https://europepmc.org/article/MED/42948027
AB - Introduction Laparoscopic and endoscopic cooperative surgery (LECS) enables accurate intraluminal localization and limited full-thickness resection while preserving gastrointestinal continuity. Although LECS has been used for selected primary duodenal tumors, its application to a postoperative duodenal recurrence of colorectal cancer has rarely been described. We report a case of localized duodenal recurrence after a right hemicolectomy that was completely resected using laparoscopic and endoscopic cooperation.Case presentation An 83-year-old man underwent a laparoscopic right hemicolectomy with a D3 lymph node dissection for advanced ascending colon cancer. Histopathological examination demonstrated a microscopically positive dissected margin on the duodenal side, indicating a microscopically positive margin (R1) resection. Nine months later, surveillance upper gastrointestinal endoscopy and contrast-enhanced CT revealed a solitary lesion in the second portion of the duodenum without distant metastasis or radiological pancreatic involvement. Endoscopic ultrasonography showed a lesion extending to the fourth layer. An upper gastrointestinal contrast study was not performed; instead, the location and local extent of the lesion were assessed by upper gastrointestinal endoscopy, endoscopic ultrasonography, and contrast-enhanced CT. Because the multimodal assessment indicated that complete local excision was technically achievable, LECS was performed. Intraoperative endoscopy delineated a wider intraluminal extent than was apparent from the serosal surface and guided an en bloc full-thickness resection. The defect was closed in the short-axis direction by a continuous full-thickness suturing. Intraoperative endoscopy confirmed the luminal patency and a negative leak test. Histopathological examination showed an adenocarcinoma involving the submucosa and muscularis propria without duodenal mucosal involvement. The adjacent muscularis propria was inverted toward the lumen, suggesting inward progression from the outer aspect of the duodenal wall. Together with the previous R1, these findings supported a localized recurrence from microscopic residual disease. The resection margins were negative, and the patient has remained disease-free for more than 5 years.Conclusions Laparoscopic and endoscopic cooperation enabled precise definition of the recurrent lesion, complete full-thickness local resection, and secure closure while preserving duodenal continuity. This approach may be useful for strictly localized duodenal recurrence when careful preoperative assessment indicates that complete local excision is achievable.
SN - 2198-7793
ER -