scholarly journals Robotic Splenic Flexure and Transverse Colon Resections

2018 ◽  
Author(s):  
Igor Monsellato ◽  
Maria Caterina Canepa ◽  
Vittorio d’Adamo ◽  
Giuseppe Spinoglio ◽  
Fabio Priora ◽  
...  
Keyword(s):  
Splenic Flexure ◽  
Transverse Colon

Laparoscopic resection of transverse colon cancer at splenic flexure: technical aspects and results

2016 ◽  
Vol 68 (1) ◽  
pp. 71-75 ◽  
Author(s):  
Junji Okuda ◽  
Masashi Yamamoto ◽  
Keitaro Tanaka ◽  
Shinsuke Masubuchi ◽  
Kazuhisa Uchiyama
Keyword(s):  
Colon Cancer ◽  
Splenic Flexure ◽  
Transverse Colon ◽  
Laparoscopic Resection ◽  
Transverse Colon Cancer ◽  
Technical Aspects

Colonic Volvulus

2014 ◽  
Author(s):  
Kevin R. Kasten ◽  
Peter W. Marcello ◽  
Todd D. Francone
Keyword(s):  
United States ◽  
Splenic Flexure ◽  
Transverse Colon ◽  
The United States ◽  
Sigmoid Volvulus ◽  
Rectal Tube ◽  
Radiographic Findings ◽  
Colonic Volvulus ◽  
Ileosigmoid Knot ◽  
Colon Volvulus

Colonic volvulus accounts for 3 to 5% of bowel obstructions in the United States. Current data reveal sigmoid volvulus as the most common colonic volvulus, followed by volvulus of the cecum, transverse colon, and splenic fixture. Despite a low incidence in the United States, diagnosis, management, and patient outcome depend on an appropriate index of suspicion and adherence to the proposed algorithm highlighting the approach to the patient with colonic volvulus. This review outlines the definition, pathogenesis, and epidemiology of colonic volvulus, as well as its clinical evaluation and treatment. Tables review the demographics of colonic volvulus in the United States, the differential diagnosis of and risk factors for colonic volvulus, important radiographic findings in colonic volvulus, and nonoperative management of sigmoid volvulus. Figures show the types of ileosigmoid knot; plain radiographs of cecal,  sigmoid, transverse, and splenic flexure volvulus; contrast enema of cecal, transverse, splenic flexure, and sigmoid volvulus; cross-sectional abdominal imaging of cecal, sigmoid, and transverse colon volvulus and ileosigmoid knot; endoscopic evaluation in sigmoid volvulus; use of an esophageal overtube for placement of a rectal tube; necrotic cecum and transverse colon volvulus in the operating suite; and sigmoid volvulus in an elderly gentleman. This review contains 14 figures, 5 tables, and 158 references.

scholarly journals Survival of colorectal cancer patients in Brunei Darussalam: comparison between 2002–09 and 2010–17

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Shirley H. F. Lee ◽  
Hanif Abdul Rahman ◽  
Nadiah Abidin ◽  
Sok King Ong ◽  
Elvynna Leong ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Overall Survival ◽  
Prognostic Factors ◽  
Splenic Flexure ◽  
Transverse Colon ◽  
Survival Rates ◽  
Brunei Darussalam ◽  
Hazard Ratios ◽  
Significant Difference ◽  
Overall Survival Rates

Abstract Background Colorectal cancer (CRC) is a major cause of cancer-related mortality worldwide. It is the second leading cause of cancer death in men and women in Brunei Darussalam in 2017, posing a major burden on society. Methods This retrospective cohort study (n = 1035 patients diagnosed with CRC in Brunei Darussalam from 1st January 2002 until 31st December 2017) aims to compare the overall survival rates of CRC patients (2002–2017), to compare survival rates between two study periods (2002–2009 and 2010–2017) and to identify prognostic factors of CRC. Kaplan-Meier estimator and log-rank tests were performed to analyse the overall survival rates of CRC patients. Multiple Cox regression was performed to determine the prognostic factors of CRC with adjusted hazard ratios (Adj. HRs) reported. Results The 1-, 3- and 5-year survival rates of CRC patients are 78.6, 62.5, and 56.0% respectively from 2002 to 2017. The 1-, 3-, and 5-year survival rates of CRC patients for 2002–2009 are 82.2, 69.6, and 64.7%; 77.0, 59.1, and 51.3% for 2010–2017 respectively. A significant difference in CRC patients’ survival rate was observed between the two study periods, age groups, ethnic groups, cancer stages, and sites of cancer (p < 0.05). The Adjusted Hazard Ratios (Adj. HRs) were significantly higher in the 2010–17 period (Adj. HR = 1.78, p < 0.001), older age group ( ≥ 60 years) (Adj. HR = 1.93, p = 0.005), distant cancer (Adj. HR = 4.69, p < 0.010), tumor at transverse colon and splenic flexure of colon (Adj. HR = 2.44, p = 0.009), and lower in the Chinese(Adj. HR = 0.63, p = 0.003). Conclusion This study highlights the lower survival rates of CRC patients in 2010–2017, Malays, older patients, distant cancer, and tumors located at the latter half of the proximal colon (transverse colon), and predominantly LCRC (splenic flexure, descending colon, sigmoid colon, overlapping lesion colon and colon (NOS), as well as the rectosigmoid junction and rectum (NOS)). Age, ethnicity, cancer stage, and tumor location are significant prognostic factors for CRC. These findings underscore the importance of public health policies and programmes to enhance awareness on CRC from screening to developing strategies for early detection and management, to reduce CRC-associated mortality.

scholarly journals A novel quantitative method via the degree of transverse colon ptosis for chronic constipation assessment

2020 ◽  
Author(s):  
Kongliang Sun ◽  
Qun Qian ◽  
Jinxiang Hu ◽  
Weicheng Liu ◽  
Yuntian Hong ◽  
...  
Keyword(s):  
Symptom Severity ◽  
Splenic Flexure ◽  
Transverse Colon ◽  
Retrospective Cohort ◽  
Obstructed Defecation ◽  
Colonic Transit ◽  
Slow Transit Constipation ◽  
X Ray ◽  
Slow Transit ◽  
Transit Constipation

ABSTRACTBACKGROUNDAssessment of colonic transit tend to be more subjective and qualitative. This study aimed to evaluate the capability of our new quantitative scale to predict the subtypes of constipation and assess symptom severity of patients with slow transit constipation.METHODSA retrospective cohort population was assembled, consisting of adult patients with chronic constipation who underwent both colonic transit test and defecography between 2012 and 2019. Radiological parameters were measured on AXRs. The Luojia score was introduced to convey the vertical distance from the splenic flexure to the lowest point of the transverse colon, representing the degree of transverse colon ptosis. Patients with slow transit constipation only were especially required to complete the Wexner Constipation Scale (WCS) and Hospital Anxiety and Depression Scale (HADS) for clinical severity assessment.FINDINGSOf 368 patients, 191 patients (51·9%) showed slow colonic transit, and patients with slow colonic transit were more likely to have severe ptosis of the transverse colon on AXRs. Patients with slow colonic transit had a significantly higher Luojia score than those with normal colonic transit (p˂0·001). A cut-off of 195 mm was used to distinguish slow colonic transit. A significant difference in Luojia score was also found between patients with obstructed defecation syndrome and normal patients, and a cut-off of 140 mm was identified. In patients with slow transit constipation, there was a strong correlation between Luojia score and WCS (r=0·618) and a moderate correlation between Luojia score and HADS-Anxiety (r=0·507). These results indicated that the Luojia score is a reliable predictor of symptom severity and psychological condition in patients with slow transit constipation.INTERPRETATIONThe Luojia score might be a new quantitative, precise method in the assessment of constipation.FUNDINGThe National Natural Science Foundation of China and the Clinical Research Special Fund of Wu Jieping Medical Foundation.Research in contextEvidence before this studyWe searched PubMed for papers published between Feb 1, 2000, and Jan 1, 2019, with the keywords “transverse colonic ptosis” OR “abdominal x-ray” AND “constipation” OR “colonic transit”. No restrictions on study type or language were implemented. Our search retrieved studies on the use of stool burden score on AXR in the assessment of constipation but no studies to use transverse colonic ptosis to evaluate colonic transit.Added value of this studyWe established a Luojia score which was defined as the vertical distance from the splenic flexure to the lowest point of transverse colon on the abdominal x-ray (AXR) that representing the degree of transverse colon ptosis. A retrospective cohort study of 368 patients proved that Luojia score has high sensitivity and specificity in distinguishing slow colonic transit and normal colonic transit as well as obstructed defecation syndrome and normal group. We were satisfied to found that in patients with slow transit constipation, there was a strong correlation between Luojia score and WCS (r=0·618) and a mediate correlation between Luojia score and HADS-A (r=0·507).Implications of all the available evidencePrecise assessment and evaluation of colonic transit play an important role in clinical diagnosis and treatment of constipation patients. Our result proved that Luojia Score is a simple and effective assessment system of certain clinic value in in identifying patients with constipation and is a potential predictor of symptom severity.

scholarly journals An Experience with Colorectal Carcinomas

2016 ◽  
Vol 9 (1) ◽  
Author(s):  
Khalid Javed Khan ◽  
Shabbir Chohan ◽  
Ammara Hassan ◽  
Tanveer Hussain Randhawa
Keyword(s):  
Colorectal Carcinoma ◽  
Prospective Study ◽  
Anal Canal ◽  
Splenic Flexure ◽  
Transverse Colon ◽  
Colorectal Carcinomas ◽  
Ascending Colon ◽  
Rectosigmoid Junction ◽  
Gender Distribution ◽  
Lesion Location

This prospective study was conducted at Sir Ganga Ram Hospital over a period of three years. All patients presenting with colorectal carcinoma were studied and included in the study. Age of the patients included in the study ranged from 18 to 74 years. Gender distribution was 12 males and 17 females. The lesions were identified in the anal canal in 3 cases and in the rectum in 9 cases. At the rectosigmoid junction in 1 case, in the splenic flexure, transverse colon and ascending colon had lesions in 3, 5, 2 cases respectively. Six lesions were identified in the caecum. All of these patients were managed surgically according to the lesion location.

Supra‐omental vs Infra‐omental approach to antegrade transverse colon release during Splenic Flexure Mobilisation ‐ a video vignette

2021 ◽  
Author(s):  
Roberto Peltrini ◽  
Maria Michela Di Nuzzo ◽  
Michele De Capua ◽  
Michele D’Ambra ◽  
Umberto Bracale ◽  
...  
Keyword(s):  
Splenic Flexure ◽  
Transverse Colon ◽  
Video Vignette

Survival of Colorectal Cancer Patients in Brunei Darussalam: Comparison between 2002-09 and 2010-17

2020 ◽  
Author(s):  
Shirley Lee ◽  
Hanif Abdul Rahman ◽  
Nadiah 'Aqilah Abidin ◽  
Sok King Ong ◽  
Elvynna Leong ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Overall Survival ◽  
Prognostic Factors ◽  
Splenic Flexure ◽  
Transverse Colon ◽  
Survival Rates ◽  
Brunei Darussalam ◽  
Hazard Ratios ◽  
Significant Difference ◽  
Overall Survival Rates

Abstract BACKGROUND Colorectal cancer (CRC) is a major cause of cancer-related mortality worldwide. It is the second leading cause of cancer death in men and women in Brunei Darussalam in 2017, posing a major burden on society. METHODS This retrospective cohort study (n = 1,035 patients diagnosed with CRC in Brunei Darussalam from 1st January 2002 until 31st December 2017) aims to compare the overall survival rates of CRC patients (2002-2017), to compare survival rates between two study periods (2002-2009 and 2010-2017) and to identify prognostic factors of CRC. Kaplan-Meier estimator and log-rank tests were performed to analyse the overall survival rates of CRC patients. Multiple Cox regression was performed to determine the prognostic factors of CRC with adjusted hazard ratios (Adj. HRs) reported. RESULTS The 1-, 3- and 5-year survival rates of CRC patients are 78.6%, 62.5%, and 56.0% respectively from 2002-2017. The 1-, 3-, and 5-year survival rates of CRC patients for 2002-2009 are 82.2%, 69.6%, and 64.7%; 77.0%, 59.1%, and 51.3% for 2010-2017 respectively. A significant difference in CRC patients’ survival rate was observed between the two study periods, age groups, ethnic groups, cancer stages, and sites of cancer (p<0.001). The Adjusted Hazard Ratios (Adj. HRs) were significantly higher in the 2010-17 period (Adj. HR=1.78, p<0.001), older age group (>=60 years) (Adj. HR=1.93, p=0.005), distant cancer (Adj. HR=4.69, p<0.010), tumor at transverse colon and splenic flexure of colon (Adj. HR=2.44, p=0.009), and lower in the Chinese group (Adj. HR=0.63, p=0.003). CONCLUSION This study highlights the lower survival rates of CRC patients in 2010-2017, Malays, older patients, distant cancer, and tumors located at the latter half of the proximal colon (transverse colon), and predominantly LCRC (splenic flexure, descending colon, sigmoid colon, overlapping lesion colon and colon (NOS), as well as the rectosigmoid junction and rectum (NOS)). Age, ethnicity, cancer stage, and tumor location are significant prognostic factors for CRC. These findings underscore the importance of public health policies and programmes to enhance awareness on CRC from screening to developing strategies for early detection and management, to reduce CRC-associated mortality.

scholarly journals A Simple Method to Improve Adenoma Detection Rate During Colonoscopy: Altering Patient Position

2013 ◽  
Vol 27 (9) ◽  
pp. 509-512 ◽  
Author(s):  
Aydin Şeref Köksal ◽  
İsmail Hakkı Kalkan ◽  
Serkan Torun ◽  
İsmail Taşkıran ◽  
Erkin Öztaş ◽  
...  
Keyword(s):  
Sigmoid Colon ◽  
Splenic Flexure ◽  
Transverse Colon ◽  
Detection Rate ◽  
Lateral Position ◽  
Adenoma Detection Rate ◽  
Colonoscopic Examination ◽  
Left Lateral Position ◽  
Patient Position ◽  
Adenoma Detection

BACKGROUND: Colonoscopy is currently considered to be the gold standard method for detecting and removing adenomatous polyps. However, tandem colonoscopy studies reveal a pooled polyp miss rate of 22%.OBJECTIVE: A prospective randomized trial was conducted to assess whether alteration of patient position during colonoscopy withdrawal increases the adenoma detection rate (ADR).METHOD: The study group included 120 patients who presented for elective colonoscopic examination. After reaching the cecum, patients were randomly assigned in a 1:1 ratio to examination in either the left lateral position or other positions (left lateral position for the cecum, ascending colon and hepatic flexure; supine for transverse colon; and supine and right lateral position for splenic flexure, descending and sigmoid colon) first. Examination of the colon was performed segment by segment. The size, morphology and location of all polyps were recorded. Polyps were removed immediately after examination of a colon segment when all positions were completed. ADR and polyp detection rates (PDR) were calculated.RESULTS: A total of 102 patients completed the study. Examination in the left lateral position revealed 66 polyps in 31 patients (PDR 30.3%) and 42 adenomas in 24 patients (ADR 23.5%). PDR increased to 43.1% (81 polyps in 44 patients) and the ADR to 33.3% (53 adenomas in 34 patients) after the colon was examined in the additional positions (P<0.001 and P=0.002, respectively). The increase in the number of adenomas detected was statistically significant in the transverse and sigmoid colon. The addition of position changes led to a 9.8% increase in the ADR in the transverse colon, splenic flexure, and descending and sigmoid colon. The frequency of surveillance interval was shortened in nine (8.8%) patients after examination of the colon in dynamic positions.CONCLUSION: Alteration of patient position during colonoscopy withdrawal is a simple and effective method to improve ADR.

scholarly journals Multicentric ameboma of the colon mimicking Crohn℉s disease

2015 ◽  
Vol 06 (02) ◽  
pp. 076-078
Author(s):  
Biggs Saravanan Ramachandran ◽  
Bright Thomas ◽  
Shana Baby ◽  
Rosamma Thomas
Keyword(s):  
Splenic Flexure ◽  
Transverse Colon ◽  
Histopathological Examination ◽  
Rare Complication ◽  
Ascending Colon ◽  
Rare Presentation ◽  
Amebic Colitis ◽  
Full Resolution ◽  
Histolytica Infection ◽  
The Right

AbstractEntamoeba histolytica infection can lead to colitis, colonic perforation abscess, and ameboma formation. Amebic colitis is common in developing countries, with its varied and nonspecific symptoms. Amebomas can occur rarely due to the formation of excess granulation tissue which usually occurs in cecum and ascending colon. A 64-year-old lady presented with abdominal pain and mass in the right side of abdomen. Imaging showed multicentric colonic masses. On colonoscopy multiple stricturizing ulcerated lesions involving cecum, ascending, proximal transverse colon, and splenic flexure were seen, which were suggestive of Crohn′s disease or multicentric neoplasm. Histopathological examination revealed multicentric lesion with focal necrosis and trophozoites of E. histolytica. Diagnosis of ameboma was made and antiamoebic treatment was started. She had full resolution of symptoms. We present this case since it is a case of ameboma, a rare complication of amebic colitis with an extremely rare presentation of multiple ulcerated stricturizing lesions, involving cecum, ascending, transverse colon, and splenic flexure which typically resembled Crohn′s disease.

CONGENITAL MEGACOLON (HIRSCHSPRUNG'S DISEASE)

PEDIATRICS ◽  
1951 ◽  
Vol 8 (4) ◽  
pp. 542-547
Author(s):  
ORVAR SWENSON
Keyword(s):  
Surgical Treatment ◽  
Large Bowel ◽  
Splenic Flexure ◽  
Transverse Colon ◽  
Ganglion Cells ◽  
Distal Colon ◽  
Transverse Colostomy ◽  
Congenital Megacolon ◽  
Clinical Experiences ◽  
Descending Colon

A NEW concept of the pathology and surgical treatment of congenital megacolon has been published. The pathology was described as absence of ganglion cells in Auerbach's plexus in the rectosigmoid and rectum. This segmental congenital defect in the myenteric plexus was postulated to account for the absence of peristalsis in the distal colon. Surgical resection of the functionally defective bowel relieved these patients. The following clinical experiences and experiments sustain this concept. Colostomy above the rectosigmoid in four patients with congenital megacolon relieved abdominal distention and colonic stasis. Six months after colostomy closure, these four patients, in whom rectosigmoid resection was not performed, suffered a complete recurrence of the disease. Reopening the colostomy in these patients again relieved all their symptoms with return of the colon to approximately normal size. The dilatation and hypertrophy of the colon seem to have been secondary to a functional obstruction in the rectum and rectosigmoid. Tracings of large bowel peristalsis were made to determine the nature of the rectosigmoid dysfunction. Three small rubber tubes with balloons attached were inserted through a transverse colostomy and positioned so that one balloon was at the splenic flexure, one in the descending colon, and one in the rectosigmoid. The balloons were inflated with 10 cc. of air and attached to recording manometers. Normal recordings were secured from two patients who had transverse colostomy as a result of right colectomy for gangrenous intussusception. The kymograph tracings showed a progression of the peristaltic waves from the transverse colon to the anus.

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