Is Laparoscopic CME Right Hemicolectomy an Optimal Indication for NET of the Right Colon and Terminal Ileum?

2020 ◽  
Author(s):  
C. Pedrazzani ◽  
C. Conti ◽  
A. Valdegamberi ◽  
M. V. Davì ◽  
S. Cingarlini ◽  
...  
Keyword(s):  
Terminal Ileum ◽  
Right Hemicolectomy ◽  
Right Colon ◽  
The Right

scholarly journals Synchronous robotic right hemicolectomy and subtotal gastrectomy

2020 ◽  
Vol 72 (4) ◽  
pp. 1273-1277
Author(s):  
Fabio Carbone ◽  
Ugo Pace ◽  
Vittorio Albino ◽  
Maddalena Leongito ◽  
Paolo Delrio
Keyword(s):  
Cancer Diagnosis ◽  
Minimal Invasive Surgery ◽  
Subtotal Gastrectomy ◽  
Right Hemicolectomy ◽  
Minimal Invasive ◽  
Right Colon ◽  
Minimal Invasiveness ◽  
Synchronous Colorectal Cancer ◽  
The Right ◽  
Robotic Resection

AbstractAbout 4% of patients with stomach cancer diagnosis have synchronous colorectal cancer and some of these patients may require a synchronous surgical resection. So far, only few minimally invasive series of synchronous resections have been described. We investigated the feasibility and safety of the synchronous robotic resection of the right colon and stomach malignancies, trying to identify a standardised and reproducible technique. It is essential to carefully plan the operation and the trocars positioning to minimise the number of robotic dockings and be able to operate comfortably. Herein, we describe our approach, which is safe and effective in terms of minimal invasiveness and oncological radicality. Robotic surgery could be used with even more advantage in complex multi-organ resections, providing the surgeon with a better vision, a more accurate dissection and longer instruments, to offer the patient all the benefits of a minimal invasive surgery.

Ischemic Conditioning in the Right Colon and Terminal Ileum: An Experimental Rat Model

2021 ◽  
Author(s):  
Gerardo Rodriguez-Leon ◽  
Fernando Estremiana ◽  
Monica Miro ◽  
Carla Bettonica ◽  
Humberto Aranda ◽  
...  
Keyword(s):  
Rat Model ◽  
Terminal Ileum ◽  
Sham Group ◽  
Esophageal Replacement ◽  
Adaptive Mechanism ◽  
Right Colon ◽  
Ischemic Conditioning ◽  
Histological Damage ◽  
Submucosal Vessel ◽  
The Right

Introduction: Preoperative gastric ischemic conditioning (IC) improves the outcome of esophageal replacement gastroplasty and is associated with low morbidity. However, when the stomach cannot be used for esophageal replacement, a colonic replacement is required. The study aim was to assess the viability of right colon and terminal ileum IC in a rat model, the histological damage/recovery sequence, and determine if neovascularization is a potential adaptive mechanism. Methods: The study was conducted in Rattus norvegicus with ileocolic vascular ligation. Seven groups of animals were established (six rats per group) with groups defined by the date of their post-IC euthanasia (+1, +3, +6, +10, +15, and +21 days). Comparisons were made with a sham group. Viability of the model was defined as <10% of transmural necrosis. The evaluation of histological damage used the Chiu score in hematoxylin and eosin sections of paraffin-embedded specimens with CD31 immunohistochemical assessment of neovascularization by the median of submucosal vessel counts in five high-magnification fields. Results: Transmural colon necrosis occurred in 1/36 animals (2.78%) with no animal demonstrating transmural ileal necrosis. The maximum damage was observed in the colon on +1 day post-IC (average Chiu score 1.67, P = 0.015), whereas in the ileum, it was on days +1, +3, and +6 (average Chiu score 1.5, 1.3, and 1.17; P = 0.015, 0.002, and 0.015, respectively). In the +21-day group, histological recovery was complete in the colon in four (66.7%) of the six animals and in the ileum in five (83.3%) of six animals. There were no significant differences in quantitative neovascularization in any of the groups when compared with the sham group or when comparisons were made between groups. Conclusions: The tested animal model for IC of the colon and terminal ileum appeared to be feasible. Histological damage was maximal between the 1st and 3rd day following IC, but by day 21, recovery was complete in two-thirds of the rats. There was no evidence in this preliminary IC model that would suggest neovascularization as an adaptive mechanism.

scholarly journals An oncological curiosity of a male patient with a huge leiomyoma of the terminal ileum

2020 ◽  
Vol 2020 (10) ◽  
Author(s):  
Syaza Zainudin ◽  
Saravana Kumar Rajanthran ◽  
Nornazirah Azizan ◽  
Firdaus Hayati ◽  
Joriana Ginawoi ◽  
...  
Keyword(s):  
Smooth Muscle ◽  
Terminal Ileum ◽  
Smooth Muscle Actin ◽  
Iliac Fossa ◽  
Gastrointestinal Stromal Tumour ◽  
Right Hemicolectomy ◽  
The Body ◽  
Muscle Fibres ◽  
Smooth Muscle Tumour ◽  
The Right

Abstract Leiomyoma is a smooth muscle tumour that can arise in any part of the body especially the uterus. Even though it is traditionally linked with hormonal influence, it can also develop in extrauterine organs with a slight female predominance. It is indistinguishable with gastrointestinal stromal tumour (GIST) histologically. We report a case of a 30-year-old gentleman who presented with a huge painful mass in the right iliac fossa. Computed tomography revealed a 10 × 10 cm homogeneous mass arising from the terminal ileum; he subsequently underwent an open right hemicolectomy. Histology showed a well-circumscribed lesion composed of interlacing bundles of smooth muscle fibres of the submucosa with positive smooth muscle actin and H-Caldesmon stains but negative for DOG-1 and CD117 (c-kit) stains which were consistent with leiomyoma. Despite its rarity, this hormone-related tumour needs to be considered regardless of gender. Immunohistochemistry is paramount as it is histologically identical to GIST.

Multicenter Controlled Study of Intracorporeal Mechanical Side-to-Side Isoperistaltic Anastomosis versus Extracorporeal Anastomosis in Laparoscopic Right Hemicolectomy: HEMI-D-TREND-Study

2019 ◽  
Vol 37 (4) ◽  
pp. 271-274 ◽  
Author(s):  
Xavier Serra-Aracil ◽  
Mireia Pascua-Solé ◽  
Laura Mora-López ◽  
Helena Vallverdú ◽  
Anna Serracant ◽  
...  
Keyword(s):  
Right Hemicolectomy ◽  
Controlled Study ◽  
Western World ◽  
Right Colon ◽  
Trend Study ◽  
Right Colon Cancer ◽  
Randomized Controlled Studies ◽  
Extracorporeal Anastomosis ◽  
The Right ◽  
Laparoscopic Anastomosis

Colorectal cancer is the second most frequent cancer in the Western world. A third of colorectal tumors are located in the right colon, and right hemicolectomy is the treatment in nondisseminated right colon cancer. The most serious complication of this procedure is anastomotic leak, which occurs in 8.4% of cases. At present, there is no standardized technique for laparoscopic ileo-colic anastomosis. In previous observational studies, intracorporeal side-to-side ileo-colic laparoscopic anastomosis has shown better results than extracorporeal anastomosis in terms of morbidity and mortality. It is known that randomized studies provide higher levels of evidence, but multicenter randomized controlled studies may imply a learning curve bias due to the differences in technical experience acquired at each hospital. As a result, we propose to carry out a prospective, controlled, nonrandomized TREND-study design (Transparent Reporting of Evaluations with Non-randomized Designs-TREND) in a large sample of 416 patients (208 per group) in order to assess the use of intracorporeal side-to-side ileo-colic laparoscopic anastomosis as the gold standard in right hemicolectomy.

scholarly journals Efficacy of infliximab treatment on the mucosal healing of different intestinal segments in patients with ileocolonic Crohn’s disease

2020 ◽  
Vol 13 ◽  
pp. 175628482097692
Author(s):  
Yaling Wu ◽  
Lei Zhang ◽  
Jingli Cao ◽  
Haichao Wang ◽  
Chen Ye ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Terminal Ileum ◽  
Transverse Colon ◽  
Mucosal Healing ◽  
Treat To Target ◽  
Infliximab Treatment ◽  
Right Colon ◽  
Single Center Study ◽  
The Right

Background: Mucosal healing (MH) is the key aim of the treat-to-target strategy for patients with Crohn’s disease (CD). The efficacy of infliximab (IFX) on MH in different ileocolonic segments is unclear. The aim of this study was to investigate endoscopic MH in different ileocolonic segments in patients with CD who received IFX treatment. Methods: A retrospective, single-center study was performed in patients with active ileocolonic CD between January 2012 and December 2018. All patients underwent IFX treatment for at least 30 weeks. The MH of five ileocolonic segments was assessed by the Simple Endoscopic Score for CD (SES-CD) at baseline, 14/22 weeks and 30/38 weeks. The SES-CD values were analyzed by a mixed-effects model after the correction for confounding factors. Results: A total of 101 eligible patients were included. The baseline endoscopic severity was similar across segments. At 30/38 weeks, the greatest changes in the SES-CD ulcer size and ulcerated surface subscores were −94.29% and −94.32% both in the transverse colon ( p < 0.0001), and the smallest changes were −67.88% and −69.67% both in the terminal ileum ( p < 0.0001) compared with baseline. Stenosis mainly presented in the right colon (12/29, 41.38%). The change in the SES-CD stenosis subscore was −6.25% in the right colon at 30/38 weeks compared with −71.88% at 14/22 weeks ( p = 0.0030). At 30/38 weeks, the transverse colon achieved the highest rate of complete MH (CMH) at 81.2%, and the lowest CMH rate occurred in the terminal ileum at 45.6%. Moreover, the degree of improvement in the rectum was negatively correlated with disease progression ( p = 0.011). Conclusions: Ileocolonic segments in CD presented different degrees of endoscopic MH during IFX treatment. The transverse colon showed the highest CMH rate, whereas the right colon with stenosis showed the poorest improvement. The differing propensities of ileocolonic segments may provide an individualized IFX treatment strategy.

scholarly journals Right retrocolic intrasaccular duodenum: Is it a novel variant of isolated duodenal nonrotation? A case report

2022 ◽  
Vol 11 ◽  
pp. 5
Author(s):  
Mirzaman Huseynov
Keyword(s):  
Terminal Ileum ◽  
Rare Variants ◽  
Ascending Colon ◽  
Right Colon ◽  
Ileocecal Region ◽  
Case Presentation ◽  
Bilious Vomiting ◽  
Novel Variant ◽  
The Right ◽  
Almost All

Background: Almost all of the studies on anomalies of the midgut rotation and fixation in the literature and related sections in textbooks were designed according to Dott's classification. Focusing only on common rotation anomalies has led to the exclusion and neglect of other rare variants. Isolated pure duodenal nonrotation is such a variant. Case Presentation: We report a case of an unusual form of isolated pure duodenal nonrotation, in a 3-day-old newborn presenting with bilious vomiting. Ultrasonographic examination revealed the sign of 'whirlpool'. When this finding was evaluated together with bilious vomiting, midgut volvulus was considered and the patient was operated on urgently. Peroperatively, it was observed that the jejunum entered between the leaves of the terminal ileum mesentery. Proximally, the duodenum was located posterior to the right colon in a "sack". This "sack" was surrounded by thick Ladd's bands laterally, mesentery of the ascending colon medially, the posterior surface of the cecum and ascending colon anteriorly, and by the posterior abdominal wall posteriorly. Conclusion: In isolated duodenal nonrotation, the duodenum may be completely retro-colic. Consequently, the duodenojejunal junction and the ileocecal region may almost overlap. Unlike isolated duodenal nonrotation cases, in the surgical treatment of this variant, separation of Ladd bands alone is not sufficient, additionally, the right colon should be placed in a nonrotation position and care should be taken not to kink the terminal ileum under the cecum.

scholarly journals Systematic review of comparing single-incision versus conventional laparoscopic right hemicolectomy for right colon cancer

2019 ◽  
Vol 17 (1) ◽  
Author(s):  
Xin Liu ◽  
Wei-hong Yang ◽  
Zhou-guang Jiao ◽  
Ji-fu Zhang ◽  
Rui Zhang
Keyword(s):  
Colon Cancer ◽  
Meta Analysis ◽  
Right Hemicolectomy ◽  
Right Colon ◽  
Chi Square ◽  
Right Colon Cancer ◽  
Laparoscopic Right Hemicolectomy ◽  
Operation Duration ◽  
The Right

Abstract Background Single-incision laparoscopic right hemicolectomy (SILS) has long used in surgery for a long time. However, there is barely a systemic review related to the comparison between the SILS and the conventional laparoscopic right hemicolectomy (CLS) for the right colon cancer in the long term follow-up. Herein, we used the most recent articles to compare these two techniques by meta-analysis. Methods We searched PubMed, Web of Science, Cochrane Library and Wanfang databases to compare SILS with CLS for right colon cancer up to May 2019. The operative, postoperative, pathological and mid-term follow-up outcomes of nine studies were extracted and compared. Results A total of 1356 patients participated in 9 studies, while 653 patients were assigned to the SILS group and 703 patients were assigned to the CLS group. The patients’ baselines in the SILS group were consistent with those in the CLS group. Compared to the CLS group, the SILS group had a shorter operation duration (SMD − 23.49, 95%CI − 36.71 to − 10.27, P < 0.001, chi-square = 24.11), shorter hospital stay (SMD − 0.76, 95% `CI − 1.07 to − 0.45, P < 0.001, chi-square = 9.85), less blood loss (SMD − 8.46, 95% CI − 14.59 to − 2.34; P < 0.05; chi-square = 2.26), smaller incision length (SMD − 1.60, 95% CI − 2.66 to − 0.55, P < 0.001; chi-square = 280.44), more lymph node harvested (SMD − 0.98, 95% CI − 1.79 to − 0.16, P < 0.05; chi-square = 4.61), and a longer proximal surgical edge (SMD − 0.51, 95% CI − 0.93 to − 0.09, P < 0.05; chi-square = 2.42). No significant difference was found in other indexes. After we removed a single large study, we performed another meta-analysis again. The operation duration in the SILS group was still better than that in the CLS group. Conclusion SILS could be a faster and more reliable approach than CLS for the right colon cancer and could accelerate patient recovery, especially for patients with a low BMI.

scholarly journals Colonic Diaphragm Disease in a Patient Receiving Long Term Diclofenac Therapy

1995 ◽  
Vol 9 (7) ◽  
pp. 413-416
Author(s):  
Alan A Weiss ◽  
David A Owen
Keyword(s):  
Abdominal Pain ◽  
Rare Complication ◽  
Right Hemicolectomy ◽  
Right Colon ◽  
Short Segment ◽  
Barium Enema Examination ◽  
Inflammatory Agent ◽  
The Right ◽  
Mucosal Folds

A 65-year-old woman who had been taking diclofenac for five years developed cramping central abdominal pain. Barium enema examination was negative, but colonoscopy revealed prominent mucosal folds in the right colon with areas of ulceration. Because of continued symptoms, a right hemicolectomy was performed, which showed four separate short segment strictures or diaphragms. This case demonstrates a rare complication of nonsteroidal anti-inflammatory agent therapy that should be considered in the differential diagnosis of unexplained abdominal pain.

Correlation of Metabolic Risk Factors with Sessile Serrated Lesions

2020 ◽  
Vol 29 (2) ◽  
pp. 175-179
Author(s):  
Melania Macarie ◽  
Simona Bataga ◽  
Simona Mocan ◽  
Monica Pantea ◽  
Razvan Opaschi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Statistical Significance ◽  
Interval Cancer ◽  
Metabolic Risk Factors ◽  
Control Group ◽  
Anatomical Site ◽  
Metabolic Risk ◽  
Right Colon ◽  
Serrated Lesions ◽  
The Right

Background and Aims: The importance of sessile serrated lesions (SSLs) in the pathogenesis of colorectal carcinoma has been recently established. These are supposed to cause the so-called “interval cancer”, having a rapidly progressive growth and being difficult to detect and to obtain an endoscopic complete resection. We aimed to establish the most important metabolic risk factors for sessile serrated lesions. Methods: We performed a retrospective case-control study, on a series of 2918 consecutive patients who underwent colonoscopy in Gastroenterology and Endoscopy Unit, County Clinical Emergency Hospital, Târgu-Mureș, Romania between 1 st of January 2015-31 th of December 2017. In order to evaluate the metabolic risk factors for polyps’ development, enrolled participants were stratified in two groups, a study group, 33 patients with SSLs lesions, and a control group, 138 patients with adenomatous polyps, selected by systematic sampling for age and anatomical site. Independent variables investigated were: gender, smoking, alcohol consumption, obesity, arterial hypertension, diabetes, hypercholesterolemia, hypertriglyceridemia, hyperuricemia, nonalcoholic liver disease. Results: For SSLs the most common encountered localization was the right colon in 30.55% of cases. By comparative bivariate analysis between SSLs group and control group, it was observed that hypertension (p=0.03, OR 2.33, 95 %CI 1.03-5.24), obesity (p=0.03, OR 2.61, 95 %CI 1.08-6.30), hyperuricemia (p=0.04, OR 2.72, 95 %CI 1.28-7.55), high cholesterol (p=0.002, OR 3.42; 95 %CI 1.48-7.87), and high triglycerides level (p=0.0006, OR 5.75; 95 %CI 1.92-17.2) were statistically associated with SSLs development. By multivariate analysis hypertension and hypertriglyceridemia retained statistical significance. Conclusions: Our study showed that the highest prevalence of SSLs was in the right colon and hypertension and increased triglycerides levels were associated with the risk of SSLs development. These risk factors are easy to detect in clinical practice and may help identifying groups with high risk for colorectal cancer, where screening is recommended.

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