Colon Resection for Cancer

Abstract Background Diaphragmatic hernias may occur as either congenital or acquired. The most important cause of acquired diaphragmatic hernias is trauma, and the trauma can be due to blunt or penetrating injury. Diaphragmatic hernia may rarely be seen after thoracoabdominal trauma. Case presentation A 54-year-old Turkish male patient admitted to the emergency department with abdominal pain and dyspnea ongoing for 2 days. He had general abdominal tenderness in all quadrants. He had a history of a stabbing incident in his left subcostal region 3 months ago without any pathological findings in thoracoabdominal computed tomography scan. New thoracoabdominal computed tomography showed a diaphragmatic hernia and fluid in the hernia sac. Due to respiratory distress and general abdominal tenderness, the decision to perform an emergency laparotomy was made. There was a 6 cm defect in the diaphragm. There were also necrotic fluids and stool in the hernia sac in the thorax colon resection, and an anastomosis was performed. The defect in the diaphragm was sutured. The oral regimen was started, and when it was tolerated, the regimen was gradually increased. The patient was discharged on the postoperative 11th day. Conclusions Acquired diaphragmatic hernia may be asymptomatic or may present with complications leading to sepsis. In this report, acquired diaphragmatic hernia and associated colonic perforation of a patient with a history of stab wounds was presented.

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Metastasectomy for Stage IVA Colon Cancer: Does the Type of Treating Institution Make a Difference?

The American Surgeon ◽

10.1177/00031348211023389 ◽

2021 ◽

pp. 000313482110233

Author(s):

Shinho T. Kang ◽

Ryan Moran ◽

Lala Hussain ◽

Hamza Guend ◽

Erik M. Dunki-Jacobs ◽

...

Keyword(s):

Colon Cancer ◽

Liver Metastasis ◽

Complex Disease ◽

Academic Research ◽

Disease Process ◽

Tumor Location ◽

Colon Resection ◽

Academic Community ◽

Metastatic Colon Cancer ◽

Isolated Liver

Treatment of metastatic colon cancer has evolved over time. More evidence has been emerging in recent years supporting metastasectomy in selected patients. We sought to elucidate whether the type of institution—community, comprehensive community, academic/research, and integrated cancer network—would have an effect on patient outcome, specifically those colon cancer patients with isolated liver metastasis. This retrospective cohort study queried the National Cancer Database (NCDB) from 2010 to 2014 for patients who were 18 years of age or older with stage IVA colon cancer with isolated liver metastasis. We then performed uni- and multivariate analyses comparing patients based on such factors as age, tumor characteristics, primary tumor location, rate of chemotherapy, and type of treating institution. Patients who came from regions of higher income, receiving chemotherapy, and presenting to an academic/research hospital were more likely to undergo metastasectomy. Median survival was longest at academic/community hospitals at 22.4 months, 6 to 7 months longer than the other three types of institutions. Factors positively affecting survival included receiving chemotherapy, presenting to an academic/research institution, and undergoing metastasectomy, all at P < .05. In our study, the rate of metastasectomy was more than double at academic/research institutions for those with stage IVA colon cancer with isolated liver metastasis. Prior studies have quoted a mere 4.1% synchronous colon resection and metastasectomy. Our findings suggest that we should maintain multidisciplinary approach to this complex disease process and that perhaps it is time for us to consider regionalization of care in treating metastatic colon cancer.

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Management of colonic diverticulitis

BMJ ◽

10.1136/bmj.n72 ◽

2021 ◽

pp. n72

Author(s):

Anne F Peery

Keyword(s):

Gastrointestinal Disease ◽

Acute Diverticulitis ◽

Anaerobic Bacteria ◽

Gastrointestinal Symptoms ◽

Colon Resection ◽

Acute Onset ◽

Colonic Diverticulitis ◽

Uncomplicated Diverticulitis ◽

Recurrent Diverticulitis ◽

Primary Resection And Anastomosis

ABSTRACT Left sided colonic diverticulitis is a common and costly gastrointestinal disease in Western countries, characterized by acute onset of often severe abdominal pain. Imaging is necessary to make an initial diagnosis and determine disease severity. Colonoscopy should be done six to eight weeks after diagnosis to rule out a missed colon malignancy. Antibiotic treatment is used selectively in immunocompetent patients with mild acute uncomplicated diverticulitis. The clinical course of diverticulitis commonly includes unpredictable recurrences and chronic gastrointestinal symptoms, which are a detriment to quality of life. A better understanding of prognosis has prompted a shift toward non-operative approaches. The decision to undergo prophylactic colon resection should be individualized to consider the severity of diverticulitis, the patient’s health and immune status, and the patient’s preferences and values, as well as benefits and risks. Because only a section of colon is removed, recurrent diverticulitis remains a risk. Acute diverticulitis with an abscess is treated with antibiotics that cover Gram negative and anaerobic bacteria, with or without percutaneous drainage. Acute diverticulitis with purulent or feculent contamination of the peritoneal cavity is managed with surgery; primary resection and anastomosis is the procedure of choice in stable patients.

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Successful Outcomes Following Large Colon Resection In Neonatal Foals

Equine Veterinary Education ◽

10.1111/eve.34_12792 ◽

2017 ◽

Vol 29 ◽

pp. 17-17

Keyword(s):

Colon Resection ◽

Successful Outcomes

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Novel assessment of intestinal anastomotic perfusion using ICG SPY in a continuous flow LVAD patient

Journal of Surgical Case Reports ◽

10.1093/jscr/rjaa445 ◽

2020 ◽

Vol 2020 (11) ◽

Author(s):

Daniel Kaufman ◽

Danny Sherwinter ◽

Ron Kaleya ◽

Paul C Saunders

Keyword(s):

Continuous Flow ◽

Axial Flow ◽

Colon Resection ◽

Left Ventricular ◽

Heartmate Ii ◽

Ventricular Assist ◽

Intestinal Anastomoses ◽

First Case ◽

Left Ventricular Assist ◽

Axial Flow Pump

Abstract HeartMate II left ventricular assist device (LVAD) assists heart failure patients by generating continuous flow via axial flow pump placed in the left ventricle. Little is known of the effect of continuous flow on intestinal anastomoses. This is the first case visually documenting altered perfusion patterns in patients with LVADs using indocyanine green (ICG). A 72-year-old male required a colon resection, for adenocarcinoma, following implantation of an LVAD. Perfusion of the anastomosis was evaluated using indocyanine. During the assessment, an unusual perfusion pattern was noticed. Normally, flow as measured by SPY is seen as an initial blush of contrast followed by a gradual, pulsatile increase in the progression of the indocyanine through the tissues. In this patient, instead of the usual initial blush, a continuous beam of ICG was seen to flow though the blood vessels. This novel perfusion pattern is consistent with flow generated from LVAD.

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