A 7-cm colon tumor that had nearly completely obstructed the bowel, combined with a history of severe trauma and multiple underlying medical conditions, placed a 90-year-old Russian man at high risk of life-threatening complications.
What surprised many was that just one day after undergoing a four-hour laparoscopic procedure at FV Hospital, the patient was able to stand and walk independently.
Emergency consultation for a highly complex case
Mr. Lazar Kogan, a 90-year-old Russian national living in Ho Chi Minh City, was admitted to hospital with intermittent abdominal pain, prolonged constipation, abdominal distension, and severe digestive disturbances – typical symptoms of bowel obstruction.
Investigations revealed a large tumor in the colon that had almost completely blocked the intestinal lumen. Without timely intervention, the patient faced the risk of bowel perforation, abdominal infection, and other life-threatening complications.
What made the case particularly challenging was not only the size of the tumor. The patient had a history of severe multiple trauma resulting in pleural adhesions, pericardial injury, and extensive abdominal adhesions. He had also previously undergone surgery for prostate cancer and was living with chronic conditions including hypertension and diabetes.
At the age of 90, any surgical intervention carries substantial risks…
Immediately after admission, the patient underwent a multidisciplinary consultation involving specialists in general surgery, oncology, anesthesiology, and imaging to comprehensively assess his condition and determine the optimal treatment strategy.
According to Dr. Le Duc Tuan, MSc., Specialist level II, General Surgery Department at FV Hospital, the greatest challenge was balancing treatment effectiveness with the patient’s ability to recover after surgery.
“If the operation is too extensive, recovery can be extremely difficult for an elderly patient. However, delaying intervention could lead to complete bowel obstruction or perforation at any time,” Dr. Tuan explained.
After careful evaluation, the team decided to perform laparoscopic surgery – a minimally invasive approach that reduces pain, lowers the risk of complications, and promotes faster recovery in elderly patients. Nevertheless, this remained a technically demanding procedure given the patient’s condition.
“Elderly patients with extensive abdominal adhesions present significant surgical challenges. We had to prepare thoroughly, from evaluating the patient’s overall condition and anesthetic risk to anticipating every possible intraoperative scenario,” Dr. Tuan said.
Four hours of meticulous dissection in an abdomen filled with adhesions
In the operating room, the surgical team encountered numerous challenges from the outset.
As a consequence of previous injuries, sections of the intestine and surrounding blood vessels were densely adhered to the abdominal wall. The tumor was also located close to the ureter – a highly delicate structure where even minor injury could result in serious complications.
The surgeons carefully dissected each layer of adhesions to gain access to the tumor while protecting surrounding organs. The process of separating adhesions between the intestines and blood vessels alone required more than 90 minutes.
After four hours of surgery, the tumor was successfully removed using laparoscopic techniques. The affected segment of the colon was then resected and reconstructed using a specialized surgical stapling device.
Notably, the patient’s vital signs remained stable throughout the procedure, and blood loss was minimal thanks to the close coordination between the surgical and anesthesiology teams.
Subsequent histopathological analysis confirmed T3 Colorectal Cancer without evidence of metastasis. Following surgery, no additional treatment was required, and the patient will continue with regular follow-up monitoring.
According to Dr. Tuan, colon cancer in older adults often develops silently and can easily be mistaken for common digestive disorders. As a result, many patients seek medical attention only after serious complications such as bowel obstruction or gastrointestinal bleeding occur.
“Successful treatment is not just about removing the tumor”
Just 24 hours after surgery, Mr. Lazar Kogan was able to stand and walk independently with assistance from medical staff.
Thanks to strict infection-control measures and a multidisciplinary postoperative care program at FV Hospital, his recovery progressed more smoothly than expected. After one week of monitoring and rehabilitation, he was discharged in stable condition.
“I first came to FV Hospital 14 years ago, and this was my fourth time receiving treatment here. I am deeply grateful to the doctors and nurses who helped me through this difficult period,” Mr. Lazar Kogan shared.
His wife, Mrs. Elena, who accompanied him throughout his treatment journey, said the professionalism and clarity of the medical team provided great reassurance.
“From our very first meeting, Dr. Le Duc Tuan gave us confidence. For us, FV is one of the best hospitals in Vietnam,” she said.
According to Dr. Tuan, many older adults tend to overlook symptoms such as persistent constipation, dull abdominal pain, or digestive disturbances. However, these symptoms may be early warning signs of serious conditions such as colon cancer or bowel obstruction.
“In elderly patients, successful treatment is not simply about removing the tumor. It is also about helping patients recover well and return to their normal lives,” Dr. Tuan emphasized.
For more information about Colon Cancer treatment at FV Hospital, readers may contact the General Surgery Department, FV Hospital, 6 Nguyen Luong Bang Street, Tan My Ward (former District 7), Ho Chi Minh City, or call the hotline at 028 3511 3333.
