Right Colon to Rectal Anastomosis (Deloyers Procedure) as a Salvage Technique for Low Colorectal or Coloanal Anastomosis

2012 ◽  
Vol 55 (3) ◽  
pp. 363-368 ◽  
Author(s):  
Gilles Manceau ◽  
Mehdi Karoui ◽  
Sylvie Breton ◽  
Anne-Sophie Blanchet ◽  
Geraldine Rousseau ◽  
...  
Keyword(s):  
Coloanal Anastomosis ◽  
Rectal Anastomosis ◽  
Right Colon ◽  
Deloyers Procedure

Modified right colon inversion technique as a salvage procedure for colorectal or coloanal anastomosis

2014 ◽  
Vol 16 (12) ◽  
pp. 971-975 ◽  
Author(s):  
C. Kontovounisios ◽  
Y. Baloyiannis ◽  
J. Kinross ◽  
E. Tan ◽  
S. Rasheed ◽  
...  
Keyword(s):  
Coloanal Anastomosis ◽  
Salvage Procedure ◽  
Right Colon ◽  
Inversion Technique

scholarly journals Extended Left Colectomy with Coloanal Anastomosis by Indocyanine Green-guided Deloyers Procedure: A Case Report

2021 ◽  
Vol 5 (2) ◽  
pp. 202-206
Author(s):  
Kazuaki Okamoto ◽  
Shigenobu Emoto ◽  
Kazuhito Sasaki ◽  
Hiroaki Nozawa ◽  
Kazushige Kawai ◽  
...  
Keyword(s):  
Case Report ◽  
Indocyanine Green ◽  
Coloanal Anastomosis ◽  
Left Colectomy ◽  
Deloyers Procedure

scholarly journals Long splenic flexure carcinoma requiring laparoscopic extended left hemicolectomy with CME and transverse-rectal anastomosis: technique for a modified partial Deloyers in 5 steps to achieve enough reach and preserving middle colic vessels

2021 ◽  
Author(s):  
Salomone Di Saverio ◽  
Kostantinos Stasinos ◽  
Weronyka Stupalkowska ◽  
Umberto Bracale ◽  
Pierpaolo Sileri ◽  
...  
Keyword(s):  
Splenic Flexure ◽  
Primary Anastomosis ◽  
Colorectal Anastomosis ◽  
Ascending Colon ◽  
Right Colon ◽  
Left Hemicolectomy ◽  
Tension Free ◽  
Descending Colon ◽  
Deloyers Procedure ◽  
The Right

Abstract Introduction This How-I-Do-It article presents a modified Deloyers procedure by mean of the case of a 67-year-old female with adenocarcinoma extending for a long segment and involving the splenic flexure and proximal descending colon who underwent a laparoscopic left extended hemicolectomy (LELC) with derotation of the right colon and primary colorectal anastomosis. Background While laparoscopic extended right colectomy is a well-established procedure, LELC is rarely used (mainly for distal transverse or proximal descending colon carcinomas extending to the area of the splenic flexure). LELC presents several technical challenges which are demonstrated in this How-I-Do-It article. Technique and methods Firstly, the steps needed to mobilize the left colon and procure a safe approach to the splenic flexure are described, especially when a tumor is closely related to it. This is achieved by mobilization and resection of the descending colon, while maintaining a complete mesocolic excision to the level of the duodenojejunal ligament for the inferior mesenteric vein and flush to the aorta for the inferior mesenteric artery. Subsequently, we depict the adjuvant steps required to enable a primary anastomosis by trying to mobilize the transverse colon and release as much of the mesocolic attachments at the splenic flexure area. Finally, we present the rare instance when a laparoscopic derotation of the ascending colon is required to provide a tension-free anastomosis. The resection is completed by delivery of the fully derotated ascending colon and hepatic flexure through a suprapubic mini-Pfannenstiel incision. The primary colorectal anastomosis is subsequently fashioned in a tension-free way and provides for a quick postoperative recovery of the patient. Results This modified Deloyers procedure preserves the middle colic since the fully mobilized mesocolon allows for a tension-free anastomosis while maintaining better blood supply to the mobilized stump. Also, by eliminating the need for a mesenteric window and the transposition of the caecum, we allow the small bowel to rest over the anastomosis and the mobilized transverse colon and reduce the possibility of an internal herniation of the small bowel into the mesentery. Conclusions Laparoscopic derotation of the right colon and a partial, modified Deloyers procedure preserving the middle colic vessels are feasible techniques in experienced hands to provide primary anastomosis after LELC with improved functional outcome. Nevertheless, it is important to consider anatomical aspects of the left hemicolectomy along with oncological considerations, to provide both a safe oncological resection along with good postoperative bowel function.

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.

CLINICAL, ENDOSCOPIC AND PATHOGICAL CHARACTERISTICS OF COLORECTAL CANCER AT DA NANG HOSPITAL FROM 2016 TO 2017

2018 ◽  
pp. 9-14
Author(s):  
Thanh Trung Nguyen ◽  
Duc Nhan Le ◽  
Van Xung Nguyen ◽  
Hieu Trung Doan
Keyword(s):  
Colorectal Cancer ◽  
Descriptive Study ◽  
Bloody Stool ◽  
Key Words Colorectal Cancer ◽  
Right Colon ◽  
Female Ratio ◽  
Histopathological Classification ◽  
Male Female Ratio ◽  
Female Male Female ◽  
Colorectal Cancer Patients

Objective: To study the clinical, endoscopy and pathogical characteristics of colorectal cancer at Da Nang Hospital. Methods: A retrospectively descriptive study, performed from 01/01/2016 to 31/12/2017 at Da Nang Hospital. Results: During two years, there were 205 cases of colorectal cancer patients hospitalized to Da Nang Hospital. Male: 59.51%, female: 40.49%, mean age: 65.8 ± 16.07. Male is higher than female, male/ female ratio is 1.4/1. The period from the first symptoms to admission < 3months predominated (83.8%). The predominant symptoms: Abdominal pain (85.85%), bloody stool (63.41%), defecation (62.44%), anemia (34.63%), weight loss (25.85%), fatigue (17.56%), abdominal distention (12.19%), nausea and vomiting (5.36%). Location of Lesions: Rectum (43.42%), sigmoid colon (20%), right colon (10.73%),cecum (10.73%), transverse colon (7.80%), left-colon (7.32%). Type of lesion on endoscopy: Exophytic (63.41%), ulceration-Exophytic (21.95%), ulceration (7.32%), polyp chemotherapy (7.32). Tumor size: ≥ 3/4 perimeter (39%), occupying the whole circumference (37.0%), occupying ≥ 1/2 perimeter (15.6%), accounting for 1/4 Perimeter (8.4%). The colon completely narrowed rate: 70.73%., incompletely was 29.27%. Histopathological classification: adenocarcinoma (85.85%), Mucinous adenocarcinoma: (9.27%) and non-differentiated epithelial carcinoma was 4.88%. Conclusion: Colorectal cancer was quite popular and was usually detected at advanced stages.Therefore, screening for subjects with risk factors for early detection and treatment is recommended. Key words: Colorectal cancer, endoscopy, pathogical characteristics...

scholarly journals Short stump and high anastomosis pull-through (SHiP) procedure for delayed coloanal anastomosis with no protective stoma for low rectal cancer

2021 ◽  
Vol 73 (2) ◽  
pp. 495-502
Author(s):  
Francesco Bianco ◽  
Paola Incollingo ◽  
Armando Falato ◽  
Silvia De Franciscis ◽  
Andrea Belli ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Local Recurrence ◽  
Coloanal Anastomosis ◽  
Functional Results ◽  
Anal Margin ◽  
Perioperative Mortality ◽  
The Mean ◽  
Pull Through ◽  
Protective Stoma

AbstractDespite advances in coloanal anastomosis techniques, satisfactory procedures completed without complications remain lacking. We investigated the effectiveness of our recently developed ‘Short stump and High anastomosis Pull-through’ (SHiP) procedure for delayed coloanal anastomosis without a stoma. In this retrospective study, we analysed functional outcomes, morbidity, and mortality rates and local recurrence of 37 patients treated using SHiP procedure, out of the 282 patients affected by rectal cancer treated in our institution between 2012 and 2020. The inclusion criterion was that the rectal cancer be located within 4 cm from the anal margin. One patient died of local and pulmonary recurrence after 6 years, one developed lung and liver metastases after 2 years, and one experienced local recurrence 2.5 years after surgery. No major leak, retraction, or ischaemia of the colonic stump occurred; the perioperative mortality rate was zero. Five patients (13.51%) had early complications. Stenosis of the anastomosis, which occurred in nine patients (24.3%), was the only long-term complication; only three (8.1%) were symptomatic and were treated with endoscopic dilation. The mean Wexner scores at 24 and 36 months were 8.3 and 8.1 points, respectively. At the 36-month check-up, six patients (24%) had major LARS, ten (40%) had minor LARS, and nine (36%) had no LARS. The functional results in terms of LARS were similar to those previously reported after immediate coloanal anastomosis with protective stoma. The SHiP procedure resulted in a drastic reduction in major complications, and none of the patients had a stoma.

Sign in / Sign up

Export Citation Format

Share Document