A 7cm colon tumour that had almost completely obstructed the bowel, combined with a history of multiple traumatic injuries and several complex underlying medical conditions, placed a 90-year-old Russian man at risk of bowel perforation and death at any time.
What was remarkable was that just one day after a four-hour laparoscopic surgery at FV Hospital, the patient was already able to stand up and walk independently.
Emergency Multidisciplinary Team Review for an Extremely High-Risk Case
Mr. Lazar Kogan (90, a Russian national living in Ho Chi Minh City) was admitted to FV Hospital with severe cramping abdominal pain, prolonged constipation, abdominal distension and significant digestive disturbances — classic signs of bowel obstruction.
Diagnostic investigations revealed a large tumour in the colon that had nearly blocked the passage of intestinal contents. Without prompt intervention, the patient faced a high risk of bowel perforation, abdominal infection and life-threatening complications.
However, the complexity of the case extended far beyond the size of the tumour. The patient had a history of severe multiple trauma, resulting in pleural adhesions, pericardial injury and extensive intra-abdominal adhesions. He had previously undergone surgery for prostate cancer and was also living with 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, anaesthesiology and intensive care, and diagnostic imaging to conduct a comprehensive assessment before determining the optimal treatment strategy.
According to Le Duc Tuan, MD, MSc, Specialist Level II, General Surgery at FV Hospital, the greatest challenge was balancing effective treatment with the patient’s ability to recover.
“If the surgery was too extensive, recovery would be extremely difficult for the patient. On the other hand, delaying treatment could result in complete bowel obstruction or bowel perforation at any time,” said Dr Tuan.
After careful consideration, the team opted for a laparoscopic approach – a minimally invasive technique that reduces pain, lowers the risk of complications and promotes faster recovery in elderly patients. Nevertheless, this approach demanded exceptional precision given the patient’s numerous risk factors.
“In elderly patients with extensive abdominal adhesions, surgery is always highly challenging. We had to prepare meticulously, from preoperative assessment and anaesthetic planning to anticipating every possible scenario during the operation,” Dr Tuan added.
Mr. Lazar Kogan made a remarkable recovery, standing and walking independently only one day after surgery.
Four Hours of Meticulous Surgery in a Severely Adhesed Abdomen
Inside the operating theatre, the surgical team faced a series of challenges from the very beginning.
Due to the patient’s previous injuries, multiple sections of bowel and blood vessels were densely adhered to the abdominal wall. The tumour was also located close to the ureter – a highly sensitive structure where even a minor error could lead to serious complications.
The surgeons carefully dissected layer by layer to reach the tumour while protecting surrounding organs. The process of releasing bowel and vascular adhesions alone took more than 90 minutes.
After four hours of continuous surgery, the tumour was successfully removed. The affected segment of colon was then resected and reconstructed using a specialised surgical stapling device that simultaneously cuts and reconnects the bowel.
Notably, the patient’s vital signs remained stable throughout the procedure, and blood loss was kept to a minimum thanks to the close coordination between the surgical and anaesthesia teams.
Pathological examination later confirmed stage T3 colon cancer without evidence of metastasis. Following surgery, the patient did not require additional treatment and will instead undergo regular follow-up monitoring.
According to Dr Le Duc Tuan, colon cancer in elderly patients often progresses silently and can easily be mistaken for common digestive disorders. Many patients seek medical attention only after serious complications such as bowel obstruction or gastrointestinal bleeding have developed.
Remarkably, Mr. Lazar Kogan made an excellent recovery, standing and walking independently just one day after surgery.
Le Duc Tuan, MD, MSc, Specialist Level II, General Surgery at FV Hospital
“Successful Treatment Is About More Than Removing the Tumour”
Just 24 hours after surgery, Mr. Lazar Kogan was able to stand up and walk with the support of the medical staff.
Thanks to FV Hospital’s strict infection control protocols and multidisciplinary postoperative care programme, his recovery progressed more smoothly than expected. After one week of monitoring and rehabilitation, the 90-year-old patient was discharged in stable condition.
“I first came to FV 14 years ago, and this is the fourth time I have received treatment here. I am truly grateful to the doctors and nurses who helped me through this critical period,” Mr. Kogan shared emotionally.
Throughout his treatment journey, his wife, Mrs. Elena, remained by his side. She said that what reassured her most was the calm, clear and reassuring approach of the medical team in every treatment decision.
“From our very first meeting, Dr Le Duc Tuan gave us confidence and peace of mind. For us, FV is one of the best hospitals in Vietnam,” she said.
Mr. and Mrs. Lazar Kogan pose for a commemorative photo with the FV medical team before Mr. Kogan’s discharge from hospital.
According to Dr Le Duc Tuan, many elderly people tend to overlook symptoms such as persistent constipation, ongoing abdominal discomfort or digestive disturbances. However, these symptoms may be early warning signs of serious conditions, including colon cancer or bowel obstruction.
“For elderly patients, successful treatment is not only about removing the tumour; it is also about ensuring a smooth recovery and helping them return to their normal daily lives,” Dr Tuan emphasised.
For more information about colon cancer treatment at FV Hospital, please contact General Surgery Department, FV Hospital, 6 Nguyen Luong Bang Street, Tan My Ward, Ho Chi Minh City, Vietnam, or call the hotline at (+84) 28 3511 3333.
