One-Stage, en Bloc Resection for Colonic-Uterine Fistula Caused by Diverticulitis

JAMA ◽  
1969 ◽  
Vol 207 (3) ◽  
pp. 555 ◽  
Author(s):  
Richard C. Clay
2021 ◽  
Vol 49 (11) ◽  
pp. 030006052110588
Author(s):  
Chih-Hisu Tu ◽  
You-Pen Chiu ◽  
Hui-Ru Ji ◽  
Cheng-Di Chiu

Primary spinal chondrosarcoma (CS) is rare. Only a few previous case reports have included a detailed description of the surgical process used to treat the CS. In addition, a paucity of documentation exists comparing differences in the outcomes between the approaches in en bloc resection. Here, we present a case of CS in the lumbar (L) spine treated with two-stage (anterior and posterior approach) en bloc surgery and analyze the differences between one-stage and two-stage approaches in the treatment of primary lumbar CS. A 30-year-old male patient with an L3 vertebral body CS presented with back pain and lower limb weakness. Lumbar spine magnetic resonance imaging (MRI) showed an L3 vertebral body tumor with cord and root compression. Two-stage surgery comprising posterior total laminectomy and transpedicular screw fixation over L2–L4 in the first stage, with subsequent anterior corpectomy, cage implantation, and anterior lumbar interbody fusion was performed to achieve total tumor removal and stabilization. The patient’s symptoms improved postoperatively, with no recurrence as of the 2-year follow-up. The analysis of previous similar cases showed that two-stage surgery, compared with one-stage surgery, appears to be beneficial in lumbar spine multisegment disease, providing a lower recurrence rate.


Endoscopy ◽  
2021 ◽  
Author(s):  
Hugo Uchima ◽  
Alberto Diez-Caballero ◽  
Jaume Capdevila ◽  
Mercé Rosinach ◽  
Alfredo Mata ◽  
...  

2021 ◽  
Vol 09 (03) ◽  
pp. E319-E323
Author(s):  
Madoka Takao ◽  
Yoshitaka Takegawa ◽  
Toshitatsu Takao ◽  
Hiroya Sakaguchi ◽  
Yoshiko Nakano ◽  
...  

Abstract Background and study aims Adequate mucosal elevation by submucosal injection is crucial for patient safety and efficiency during endoscopic submucosal dissection (ESD). This study aimed to evaluate the efficacy of fibrin glue (FG) as a long-lasting submucosal injection agent and to evaluate the technical feasibility of FG injection for ESD. Materials and methods To compare the capabilities of different agents in maintaining submucosal evaluation, we injected FG, hyaluronic acid solution, and normal saline into the porcine gastric specimen that was incised into approximately 5 × 5 cm squares. Then, we measured the height of submucosal elevations over time. Moreover, three hypothetical lesions from the resected porcine stomach underwent ESD with FG injection. Thereafter, we conducted macroscopic and histopathologic analyses. Results FG maintained the greatest submucosal elevation among all the injection agents. Three ESD procedures were performed with en bloc resection. Both macroscopic and histopathologic findings showed a thick FG clot on the ulcers. Conclusions The FG solution can be potentially used as an ESD submucosal injection agent in an in vitro model.


2021 ◽  
Vol 09 (05) ◽  
pp. E653-E658
Author(s):  
Tatsuma Nomura ◽  
Yoshikazu Hayashi ◽  
Takaaki Morikawa ◽  
Masahiro Okada ◽  
Hisashi Fukuda ◽  
...  

Abstract Background and study aims The pocket-creation method (PCM) facilitates dissection of the central part of a tumor. We previously developed the PCM with clip traction (PCM-CT) to facilitate opening the mucosal pocket, which otherwise could become cumbersome. In the present study, we aimed to examine the feasibility of PCM-CT for colorectal endoscopic submucosal dissection (ESD). Patients and methods PCM-CT was performed on 30 patients with early colorectal tumors from October 2019 to April 2020. PCM-CT allows efficient opening of the mucosal pocket by using the PCM to dissect the center of the lesion and then apply traction with a single clip after making a circumferential mucosal incision. Results The median specimen major axis length, ESD time, ESD speed, and en bloc resection rate were 48 mm, 84 minutes, 20 mm2/min, and 100 % (30/30), respectively. The success rates for the traction clip and median single-clip-traction time were 100 % (30/30) and 1.5 minutes, respectively. Conclusions Colorectal ESD using PCM-CT is a simple and promising method.


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