Three‐step measures of endoscopic polyp localization in laparoscopic segmental colectomy

2021 ◽  
Vol 91 (9) ◽  
pp. 1948-1949
Author(s):  
Wei Wang ◽  
Feng Tao ◽  
Jieqing Lv
Keyword(s):  
Segmental Colectomy

Segmental Colectomy

1999 ◽  
pp. 303-307
Author(s):  
Denis C. N. K. Nyam ◽  
John H. Pemberton
Keyword(s):  
Segmental Colectomy

Diffuse Giant Inflammatory Polyposis: A Challenging Clinicopathologic Diagnosis

2004 ◽  
Vol 128 (11) ◽  
pp. 1286-1288
Author(s):  
Mohammad-Reza Sheikholeslami ◽  
Robert F. Schaefer ◽  
Perkins Mukunyadzi
Keyword(s):  
Surgical Resection ◽  
Acute Inflammation ◽  
Postoperative Recovery ◽  
Resection Margins ◽  
Colonoscopic Examination ◽  
Presenting Symptoms ◽  
Adjacent Mucosa ◽  
Segmental Colectomy ◽  
Inflammatory Bowel ◽  
Inflammatory Polyposis

Abstract Giant inflammatory polyposis of the colon is an uncommon manifestation of inflammatory bowel disease. We report a unique case of localized diffuse giant inflammatory polyposis in a 58-year-old white man, which was characterized by recurrence following initial surgical resection. The patient presented with symptoms of abdominal pain and passing blood per rectum. Colonoscopic examination revealed a near-obstructing, “fungating” mass in the sigmoid colon, which clinically was thought to represent colon carcinoma. Histology of several colon biopsies revealed marked acute inflammation with microabscess formation of the polyps and the adjacent mucosa. There was no evidence of dysplasia or malignancy. Because malignancy was strongly suspected and to relieve the obstructive symptoms, the patient underwent a segmental colectomy. The histologic features of the resected mass showed giant polyps with acute inflammation diagnostic of giant inflammatory polyposis. Again, there was no evidence of malignancy. Seven months later, following an uneventful initial postoperative recovery, the patient developed a recurrence of the mass with obstructive symptoms and required further surgical resection. The gross and histologic features of the lesion were similar to the previous findings. This case highlights the varied presenting symptoms and deceptive gross colonoscopic and radiologic features of localized diffuse giant inflammatory polyposis. Finally, the presence of inflammation at the resection margins appears to predict recurrence or persistence of the disease.

Dedifferentiated Liposarcoma of the Transverse Colon

2021 ◽  
pp. 000313482110545
Author(s):  
Katie Fitzgerald ◽  
Eliza M. Slama ◽  
Irina Bernescu
Keyword(s):  
Transverse Colon ◽  
Soft Tissue Sarcomas ◽  
Surgical Excision ◽  
Dedifferentiated Liposarcoma ◽  
High Grade ◽  
Nodal Involvement ◽  
Segmental Colectomy ◽  
Aggressive Tumor ◽  
Disease Free

While liposarcoma is one of the most common soft tissue sarcomas, it is rarely seen within the gastrointestinal tract, and even less frequently seen within the colon. Dedifferentiated liposarcoma is a subtype of liposarcoma, which along with the pleomorphic subtype is considered a high-grade, aggressive tumor; both possess the ability to metastasize and are associated with decreased survival. Despite complete resection, recurrence is common. While surgical excision is the cornerstone of treatment for liposarcoma of the colon, there is no consensus on adjuvant therapies. We present the case of a 66-year-old woman who presented with abdominal pain with rectal bleeding and was found on colonoscopy to have a high-grade dedifferentiated liposarcoma of the transverse colon. She underwent robotic segmental colectomy. Due to absence of nodal involvement or distal metastasis, adjuvant therapy was not administered. On 1-year follow-up, the patient remains disease free.

scholarly journals Surgical treatment of colonic Crohn’s disease: a national snapshot study

2020 ◽  
Author(s):  
Keyword(s):  
Crohn’S Disease ◽  
Surgical Treatment ◽  
Crohn's Disease ◽  
Hospital Stay ◽  
Subtotal Colectomy ◽  
Postoperative Morbidity ◽  
Elective Surgery ◽  
Length Of Hospital Stay ◽  
High Rate ◽  
Segmental Colectomy

Abstract Aim The different surgical options for patients with colonic Crohn’s disease (CD) include segmental colectomy, subtotal colectomy or proctocolectomy with end ileostomy. We present a national, multicentre study, promoted by the Italian Society of Colorectal Surgery with the aim to collect benchmark data and national variations on multidisciplinary management and postoperative outcomes of patients undergoing surgery for colonic CD. Methods All adult patients having elective surgery for colonic CD from June 2018 to May 2019 were eligible for participation in this retrospective study. The primary outcome measure was postoperative morbidity within 30 days of surgery. Results One hundred twenty-two patients were included: 55 subtotal colectomy, 30 segmental colectomy, 25 proctectomy and 12 proctocolectomy. Eighty-six patients (70.4%) were discussed at the inflammatory bowel disease (IBD) multidisciplinary team meeting (MDT) prior to surgery. This ranged from 76.6% for segmental colectomy to 60% for subtotal colectomy, 66.6% for proctocolectomy and 48% for proctectomy. The proportion of patients counselled by a stoma nurse preoperatively was 50%. Laparoscopy was associated with reduced postoperative morbidity (p = 0.017) and shorter length of hospital stay (p < 0.001), whilst pre-operative anti-TNF was associated with Dindo-Clavien ≥ 3 complications (p = 0.023) and longer in-hospital stay (p = 0.007). The main procedure performed (segmental colectomy, subtotal colectomy, proctocolectomy or proctectomy) was not associated with postoperative morbidity (p = 0.626). Conclusions Surgery for colonic CD has a high rate of postoperative complications. Almost a third of the patients were not preoperatively discussed at the IBD MDT, whilst the use of minimally invasive surgery for surgical treatment of colonic CD ranges from 40 to 66%.

Laparoscopic-Assisted Segmental Colectomy: Surgical Techniques

1994 ◽  
Vol 69 (9) ◽  
pp. 825-833 ◽  
Author(s):  
TODD D. ELFTMANN ◽  
HEIDI NELSON ◽  
DAVID M. OTA ◽  
JOHN H. PEMBERTON ◽  
ROBERT W. BEART
Keyword(s):  
Surgical Techniques ◽  
Segmental Colectomy ◽  
Laparoscopic Assisted

scholarly journals Intestinal Perforation due to Deep Infiltrating Endometriosis during Pregnancy: Case Report

2018 ◽  
Vol 40 (04) ◽  
pp. 235-238 ◽  
Author(s):  
Márcia Carneiro ◽  
Luciana Costa ◽  
Maria Torres ◽  
Patrícia Gouvea ◽  
Ivete Ávila
Keyword(s):  
Transvaginal Ultrasound ◽  
Deep Infiltrating Endometriosis ◽  
Intestinal Lesion ◽  
Gnrh Analogues ◽  
Extrinsic Compression ◽  
Intestinal Lesions ◽  
Ovarian Endometrioma ◽  
Laparoscopic Excision ◽  
Segmental Colectomy ◽  
Peritoneal Infection

AbstractWe report the case of a 33 year-old woman who complained of severe dysmenorrhea since menarche. From 2003 to 2009, she underwent 4 laparoscopies for the treatment of pain associated with endometriosis. After all four interventions, the pain recurred despite the use of gonadotropin-releasing hormone (GnRH) analogues and the insertion of a levonorgestrel intrauterine system (LNG-IUS). Finally, a colonoscopy performed in 2010 revealed rectosigmoid stenosis probably due to extrinsic compression. The patient was advised to get pregnant before treating the intestinal lesion. Spontaneous pregnancy occurred soon after LNG-IUS removal in 2011. In the 33rd week of pregnancy, the patient started to feel severe abdominal pain. No fever or sings of pelviperitonitis were present, but as the pain worsened, a cesarean section was performed, with the delivery of a premature healthy male, and an intestinal rupture was identified. Severe peritoneal infection and sepsis ensued. A colostomy was performed, and the patient recovered after eight days in intensive care. Three months later, the colostomy was closed, and a new LNG-IUS was inserted. The patient then came to be treated by our multidisciplinary endometriosis team. The diagnostic evaluation revealed the presence of intestinal lesions with extrinsic compression of the rectum. She then underwent a laparoscopic excision of the endometriotic lesions, including an ovarian endometrioma, adhesiolysis and segmental colectomy in 2014. She is now fully recovered and planning a new pregnancy. A transvaginal ultrasound (TVUS) performed six months after surgery showed signs of pelvic adhesions, but no endometriotic lesions.

Feasibility and Safety of Intraoperative Colonoscopy after Segmental Colectomy and Primary Anastomosis

2018 ◽  
Vol 84 (7) ◽  
pp. 1175-1179 ◽  
Author(s):  
Erika L. Simmerman ◽  
Ray S. King ◽  
P. Benson Ham ◽  
Vendie H. Hooks
Keyword(s):  
Primary Anastomosis ◽  
Tertiary Care ◽  
Length Of Hospital Stay ◽  
Operation Time ◽  
Accurate Diagnosis ◽  
Intraoperative Colonoscopy ◽  
Preoperative Colonoscopy ◽  
Segmental Colectomy ◽  
Tertiary Care Institution ◽  
To Receive

Patients presenting with near-obstructing colon lesions requiring segmental colectomy may benefit from intraoperative colonoscopy (IOC) after primary anastomosis for a more timely and accurate diagnosis of synchronous lesions. The aim of this study is to demonstrate the feasibility and safety of this technique. A retrospective cohort study of patients undergoing single-stage segmental colectomy and anastomosis at a single tertiary care institution from 2011 to 2013 was performed. One Hundred and sixty-eight consecutive patients underwent segmental colectomy and primary anastomosis of which 78 (46%) were unable to receive preoperative colonoscopy (POC) because of near-obstructing lesions and received IOC after the anastomosis. IOC detected synchronous adenomatous polyps in 24.4 per cent, diverticular disease in 19 per cent, and colitis/proctitis in 2.5 per cent. The IOC group was not significantly different from the POC group with regard to overall morbidity (31% vs 39% P = 0.45), anastomotic leakage (1.3% vs 0%, P = 0.46), or wound infection (5.1% vs 1.1%, P = 0.18). Operation time was 19 minutes longer in the intra-operative group, but overall length of hospital stay was not significantly different (6.4 ± 2.9 days vs 7.3 ± 4.6 days). In patients unable to receive POC because of partial obstruction, IOC after primary anastomosis is both feasible and safe for detecting proximal synchronous lesions.

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