Salvage of Total Esophageal Reconstruction with Microvascular Free Left Colon Flap

2002 ◽  
Vol 18 (4) ◽  
pp. 261-262 ◽  
Author(s):  
Chris D. Tzarnas ◽  
William S. Wittenborn ◽  
Joseph D. Whitlark ◽  
William H. Ayers
Keyword(s):  
Left Colon ◽  
Esophageal Reconstruction ◽  
Free Left

Surgical outcome of left colon interposition for esophageal reconstruction

2010 ◽  
Vol 6 (1) ◽  
pp. 54-61
Author(s):  
Jong-Tae Park ◽  
Hyoung-Il Kim ◽  
Hyoung-Won Cho ◽  
Choong-Bai Kim
Keyword(s):  
Surgical Outcome ◽  
Left Colon ◽  
Colon Interposition ◽  
Esophageal Reconstruction

A Case of Multiple Polyps Originating in a Skin Tube for Esophageal Reconstruction.

1994 ◽  
Vol 45 (4) ◽  
pp. 334-337
Author(s):  
Nobuhiko Nishino ◽  
Katsunori Aoki ◽  
Hiroyuki Konno ◽  
Yuji Maruo ◽  
Tatsuo Tanaka ◽  
...  
Keyword(s):  
Esophageal Reconstruction ◽  
Skin Tube

SIMULTANEOUS ESOPHAGO-GASTRECTOMY WITH COLONIC INTERPOSITION AS A METHOD OF SURGICAL TREATMENT OF GASTROESOPHAGEAL CANCER WITH HIGH INVOLVEMENT OF THE ESOPHAGUS

2017 ◽  
Vol 63 (1) ◽  
pp. 146-152
Author(s):  
Mikhail Ter-ovanesov ◽  
Aleksandr Levitskiy ◽  
E. Lesnidze ◽  
Aram Gaboyan ◽  
Mariya Kukosh ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Long Term Results ◽  
Esophageal Reconstruction ◽  
Gastroesophageal Cancer ◽  
Colonic Interposition ◽  
Simultaneous Application ◽  
High Involvement ◽  
Surgical Access ◽  
Critical Overview

In the current oncological practice surgical treatment of gastroesophageal cancer with high involvement of the esophagus can extend to total esophago-gastrectomy with colonic interposition as the main method of radical treatment. However the technical complexity and high risk of the intervention are factors in determining the divergent views on the operation itself, testimony for the criteria of patient’s selection, choice of surgical access and the formation of a colonic graft in conjunction with method of esophageal reconstruction. The long-term results of operative intervention depend primarily on the extent of tumor process but obviously higher than after conservative treatment. This article presents a brief critical overview of the main aspects of the simultaneous application of esophago-gastrectomy in surgery of gastroesophageal cancer with high esophageal involvement and our clinical case of successful surgical treatment of a woman with pregnancy-associated gastroesophageal cancer.

Use of indocianine green fluorescence in acute mesenteric ischemia

2020 ◽  
Vol 3 (2) ◽  
Author(s):  
Jaime Bonnín-Pascual
Keyword(s):  
Indocyanine Green ◽  
Terminal Ileum ◽  
Mesenteric Ischemia ◽  
Intestinal Anastomosis ◽  
Acute Mesenteric Ischemia ◽  
Left Colon ◽  
Infrared Light ◽  
High Morbidity ◽  
Green Fluorescence ◽  
Clinical Cases

Introduction: Acute mesenteric ischemia has a high morbidity and mortality and constitutes an intraoperative challenge in the management of ischemic areas. In this context, we analyze the use of indocyanine green fluorescence to assess intestinal vascularization through 3 clinical cases. Case presentation: we present 3 clinical cases operated for acute mesenteric ischemia. Evaluation of intestinal viability is performed under infrared light after intravenous infusion of 25 mg of indocyanine green. Case 1 is a 42-year-old male with multiple antecedents of severe vascular disease, presenting with a massive acute mesenteric ischemia involving multiple intestinal segments. Fluorescence allows two adjusted bowel resections with double intestinal anastomosis. Case 2 is a 74-year-old woman with a history of non-anticoagulated atrial fibrillation who is decided to perform an urgent surgery when an esophageal, gastric and portal system pneumatosis is observed, as indirect signs of ischemia, in urgent CT. During the surgical act there is an ischemia of the terminal ileum and right colon without clear signs of involvement at the esophageal-gastric level. The assessment after administration of ICG discriminates the clear ischemic involvement from terminal ileum to ascending colon and patched in the transverse and left colon, without esophageal or gastric involvement. Case 3 is a 49-year-old woman with aortoiliac and visceral Takayasu disease and revascularization surgery of the celiac trunk. Given the increase in abdominal pain, a new CT scan demonstrates colonic pneumatosis. Urgent laparotomy shows necrosis at the level of the left colon and hypoperfusion of the cecum. The administration of ICG finds a lack of uptake of the entire colon. A subtotal colectomy with ileostomy and mucous fistula is performed. Introduction: Acute mesenteric ischemia has a high morbidity and mortality and constitutes an intraoperative challenge in the management of ischemic areas. In this context, we analyze the use of indocyanine green fluorescence to assess intestinal vascularization through 3 clinical cases. Case presentation: we present 3 clinical cases operated for acute mesenteric ischemia. Evaluation of intestinal viability is performed under infrared light after intravenous infusion of 25 mg of indocyanine green. Case 1 is a 42-year-old male with multiple antecedents of severe vascular disease, presenting with a massive acute mesenteric ischemia involving multiple intestinal segments. Fluorescence allows two adjusted bowel resections with double intestinal anastomosis. Case 2 is a 74-year-old woman with a history of non-anticoagulated atrial fibrillation who is decided to perform an urgent surgery when an esophageal, gastric and portal system pneumatosis is observed, as indirect signs of ischemia, in urgent CT. During the surgical act there is an ischemia of the terminal ileum and right colon without clear signs of involvement at the esophageal-gastric level. The assessment after administration of ICG discriminates the clear ischemic involvement from terminal ileum to ascending colon and patched in the transverse and left colon, without esophageal or gastric involvement. Case 3 is a 49-year-old woman with aortoiliac and visceral Takayasu disease and revascularization surgery of the celiac trunk. Given the increase in abdominal pain, a new CT scan demonstrates colonic pneumatosis. Urgent laparotomy shows necrosis at the level of the left colon and hypoperfusion of the cecum. The administration of ICG finds a lack of uptake of the entire colon. A subtotal colectomy with ileostomy and mucous fistula is performed. Conclusions: The fluorescence with ICG provides a better visualization of the intestinal vascularization in the AMI, and allows to determine the limits of the affected tissue to perform adjusted resections.

scholarly journals Congestive ischemic colitis occurring after resection of left colon cancer: 4 case series

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Takatsugu Fujii ◽  
Shigeo Toda ◽  
Yuki Nishihara ◽  
Yusuke Maeda ◽  
Kosuke Hiramatsu ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Ischemic Colitis ◽  
Case Series ◽  
Left Colon ◽  
Left Colon Cancer

Factors Influencing the Outcome of Intestinal Anastomosis

2011 ◽  
Vol 77 (9) ◽  
pp. 1169-1175 ◽  
Author(s):  
Juan J. LujÁN ◽  
ZoltÁN H. NÉMeth ◽  
Patricia A. Barratt-Stopper ◽  
Rami Bustami ◽  
Vadim P. Koshenkov ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Blood Loss ◽  
Surgical Site Infection ◽  
Bowel Disease ◽  
Intestinal Anastomosis ◽  
Significant Risk ◽  
Left Colon ◽  
Site Infection ◽  
Intraoperative Blood Loss ◽  
Inflammatory Bowel

Anastomotic leak (AL) is one of the most serious complications after gastrointestinal surgery. All patients aged 16 years or older who underwent a surgery with single intestinal anastomosis at Morristown Medical Center from January 2006 to June 2008 were entered into a prospective database. To compare the rate of AL, patients were divided into the following surgery-related groups: 1) stapled versus hand-sewn, 2) small bowel versus large bowel, 3) right versus left colon, 4) emergent versus elective, 5) laparoscopic versus converted (laparoscopic to open) versus open, 6) inflammatory bowel disease versus non inflammatory bowel disease, and 7) diverticulitis versus nondiverticulitis. We also looked for surgical site infection, estimated intraoperative blood loss, blood transfusion, comorbidities, preoperative chemotherapy, radiation, and anticoagulation treatment. The overall rate of AL was 3.8 per cent. Mortality rate was higher among patients with ALs (13.3%) versus patients with no AL (1.7%). Open surgery had greater risk of AL than laparoscopic operations. Surgical site infection and intraoperative blood transfusions were also associated with significantly higher rates of AL. Operations involving the left colon had greater risk of AL when compared with those of the right colon, sigmoid, and rectum. Prior chemotherapy, anticoagulation, and intraoperative blood loss all increased the AL rates. In conclusion, we identified several significant risk factors for ALs. This knowledge should help us better understand and prevent this serious complication, which has significant morbidity and mortality rates.

scholarly journals Racial Disparities in Epigenetic Aging of the Right vs Left Colon

2020 ◽  
Author(s):  
Matthew Devall ◽  
Xiangqing Sun ◽  
Fangcheng Yuan ◽  
Gregory S Cooper ◽  
Joseph Willis ◽  
...  
Keyword(s):  
Dna Methylation ◽  
African Americans ◽  
Racial Differences ◽  
Age Of Onset ◽  
Left Colon ◽  
Right Colon ◽  
Normal Colon ◽  
Epigenetic Aging ◽  
Epigenetic Age Acceleration ◽  
The Right

Abstract There are well-documented racial differences in age-of-onset and laterality of colorectal cancer. Epigenetic age acceleration is postulated to be an underlying factor. However, comparative studies of side-specific colonic tissue epigenetic aging are lacking. Here, we performed DNA methylation analysis of matched right and left biopsies of normal colon from 128 individuals. Among African Americans (n = 88), the right colon showed accelerated epigenetic aging as compared to individual-matched left colon (1.51 years; 95% CI = 0.62 to 2.40 years; two-sided P = .001). In contrast, among European Americans (n = 40), the right colon shows remarkable age deceleration (1.93 years; 95% CI = 0.65 to 3.21 years; two-sided P = .004). Further, epigenome-wide analysis of DNA methylation identifies a unique pattern of hypermethylation in African American right colon. Our study is the first to report such race and side-specific differences in epigenetic aging of normal colon, providing novel insight into the observed younger age-of-onset and relative preponderance of right-side colon neoplasia in African Americans.

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