Laparoscopic Colectomy for Colon Cancer After Liver Transplantation

Gustavo Rossi, MD, Ricardo Mentz, MD, Carlos A. Vaccaro, MD, PhD, Fernando A. Alvarez, MD,
Guillermo Ojea Quintana, MDSection of Colon and Rectal Surgery, Department of General Surgery, Hospital Italiano de Buenos Aires, Juan D. Peron 4190, C1181ACH, Buenos Aires, Argentina (all authors).

ABSTRACTIntroduction: Colon cancer in liver transplant patients is an uncommon clinical situation. These patients are considered of high risk and are classically treated with an open approach. Currently, there are very few reports in the literature regarding laparoscopic colectomy in the case of solid-organ transplant patients and none concerning a straight laparoscopic colectomy in a liver transplant patient.

Case Description: We present a 63-year-old female patient with a history of liver transplantation, who developed a left colon cancer 3 years after surgery. The tumor was located in the sigmoid colon, approximately 20 cm from the anal verge. The serum carcinoembryonic antigen was 4.5 ng/mL and a thoracoabdominal computed tomography scan ruled out metastatic disease. Surgery was scheduled and a laparoscopic left colectomy was successfully performed. The postoperative course was uneventful, and the patient was discharged on postoperative day 3. After a 28-month follow-up, the patient remains free of disease.

Discussion: To the best of our knowledge, the present case represents the first reported straight laparoscopic colectomy in a liver transplant recipient. Laparoscopic colectomy for colon cancer in previous liver transplant patients is feasible and may be safely performed in the hands of experienced colorectal surgeons. Due to the known benefits of laparoscopic surgery, this alternative appears to be worthwhile and should be considered in selected liver transplant patients.

Key Words: Colon cancer, Laparoscopic colectomy, Laparoscopy, Liver transplantation

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