Minimally invasive treatment of multiple primary tumors of the gastrointestinal tract. Clinical observation

   For now days we don’t have any guidelines for the treatment of synchronous and metachronous tumors of the upper and lower gastrointestinal tract. In this case report, we are talking about optimal treatment strategy in a patient with early gastric cancer, a neuroendocrine tumor of the sigmoid colon, and a locally advanced rectal cancer. The patient underwent laparoscopic gastrectomy and endoscopic excision of the early neuroendocrine tumor of the sigmoid colon. View of the local advanced rectal cancer patient underwent combined preoperative “sandwich” treatment with 2 courses of chemotherapy before a long course of chemoradiotherapy and 2 courses of chemotherapy after. The treatment was well tolerated. Ten weeks later, the patient gets surgical procedure: laparoscopic low anterior resection with loop colostomy followed by adjuvant chemotherapy. At the end of chemotherapy colostomy closure was done. The minimally invasive surgical treatment is safe and feasible in patients with synchronous malignancies of upper and lower gastrointestinal tract. Fast track rehabilitation and minimal surgical trauma ensure timely delivery of chemotherapy.

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