scholarly journals Sigmoid Carcinoma in an Inguinal Hernia: A Blessing in Disguise?

2013 ◽  
Vol 2013 ◽  
pp. 1-3
Author(s):  
P. B. Salemans ◽  
G. F. Vles ◽  
S. A. F. Fransen ◽  
R. M. Smeenk

Colorectal cancer is a rising problem, as the incidence increases with age. In most cases the goal of treatment is oncological resection followed by adjuvant chemotherapy in order to optimize the survival. In this case report we present a 93-year-old patient with a sigmoid carcinoma inside an irreducible inguinal hernia, which was diagnosed prior to surgery. We chose to perform a sigmoid resection through an oblique inguinal incision as a safer alternative to laparotomy.

2013 ◽  
Vol 31 (4_suppl) ◽  
pp. 549-549 ◽  
Author(s):  
Sanjay S. Reddy ◽  
Elin R. Sigurdson ◽  
Jeffrey M. Farma

549 Background: Laparoscopic (LS) and robotic surgery (RS) for colorectal cancer provides a new perspective of the deep pelvis. Our goal was to identify the role of LS and RS for patients with sigmoid and rectal cancer. Methods: We retrospectively analyzed 53 patients treated from 2007-2012. Resection type, previous surgery, neoadjuvant and adjuvant therapy, timing of surgery, lymph nodes (LN) harvested, estimated blood loss (EBL), operative time (OT), complications, and pathology were reviewed. Results: Of 53 patients, 32 underwent LS, and 18 RS. There were 47 patients with adenocarcinoma, 5 with unresectable polyps and 1 with anal melanoma. 62% of patients underwent a recto-sigmoid resection, 23% rectal, and 8% sigmoid. 32% had prior surgery. Neoadjuvant treatment (NAT) was initiated in 31 patients; 3 received chemotherapy without radiation, and 1 short course radiation. An average of 12.8 and 8.4 LN were harvested in the LS and RS groups respectively, with a mean of 9.9 LN after NAT, and 13.9 without. EBL was 155ml (20-650) with LS and 178ml (25-600) with RS. 3 LS cases were converted to an open procedure. Median OT was 270 and 302 minutes for LS and RS groups. Using the Clavien grading system, 12 patients had grade 1-2 complications, 5 grade 3, and 2 grade 4’s within 30 days. Radial margins were positive in 2 patients; one received NAT for a fungating anal adenocarcinoma, and the other had chemotherapy alone. One patient had a positive proximal margin with no prior therapy. Rate of complete pathological response (pCR) was 35%, and 71% were down staged. The mean interval between completion of NAT and resection was 8 weeks (range 4-12), and surgery to adjuvant therapy was 8 weeks (range 4-22). Conclusions: LS and RS surgery for colorectal cancer can be safely performed in conjunction with neoadjuvant and/or adjuvant chemotherapy. NAT should not preclude adoption of these techniques, as we achieved a 35% pCR with minimal operative morbidity allowing patients to proceed to adjuvant chemotherapy in a timely fashion. [Table: see text]


2021 ◽  
Vol 19 (1) ◽  
Author(s):  
You Zou ◽  
Shuang Liu ◽  
Jianhong Wu ◽  
Zhen Sun

Abstract Background Capecitabine is a prodrug that is enzymatically converted to its active form, fluorouracil (also called 5-fluorouracil), which is commonly used as adjuvant chemotherapy in colorectal cancer patients. Severe gastrointestinal bleeding induced by capecitabine is rare. Here, we are presenting the first case report of surgery specimen assisted diagnosis of this uncommon condition. Case presentation A 63-year-old Chinese male with a history of colon adenocarcinoma and right hemicolectomy presented with severe lower gastrointestinal bleeding 2 days after finishing capecitabine administration during the first cycle of XELOX adjuvant chemotherapy. Because of the negative findings of active bleeding points by digital subtraction angiography (DSA) or colonoscopy, emergency laparotomy and partial enterectomy were performed. The bloody diarrhea had resolved after surgery and a terminal ileitis was diagnosed after pathological examination of the surgical specimen. Conclusions Terminal ileitis induced by capecitabine is likely to be underreported. It should be considered more often as a cause of severe gastrointestinal bleeding during or after treatment with capecitabine agents. Emergency surgery may achieve satisfactory outcomes if endoscopic hemostasis is ineffective. Highlights of this case 1. Gastrointestinal bleeding following capecitabine treatment in colorectal cancer patients might be life-threatening. 2. Terminal ileitis induced by capecitabine should always be considered in the differential diagnosis of severe gastrointestinal bleeding. 3. Awareness of the risk factors such as deficiency of dihydropyrimidine dehydrogenase, advanced age, or right colectomy may aid in reducing capecitabine-related morbidity. 4. When severe bleeding occurs, emergency surgery may achieve satisfactory outcomes if medical and endoscopic interventions are ineffective.


Swiss Surgery ◽  
2003 ◽  
Vol 9 (1) ◽  
pp. 3-7 ◽  
Author(s):  
Gervaz ◽  
Bühler ◽  
Scheiwiller ◽  
Morel

The central hypothesis explored in this paper is that colorectal cancer (CRC) is a heterogeneous disease. The initial clue to this heterogeneity was provided by genetic findings; however, embryological and physiological data had previously been gathered, showing that proximal (in relation to the splenic flexure) and distal parts of the colon represent distinct entities. Molecular biologists have identified two distinct pathways, microsatellite instability (MSI) and chromosomal instability (CIN), which are involved in CRC progression. In summary, there may be not one, but two colons and two types of colorectal carcinogenesis, with distinct clinical outcome. The implications for the clinicians are two-folds; 1) tumors originating from the proximal colon have a better prognosis due to a high percentage of MSI-positive lesions; and 2) location of the neoplasm in reference to the splenic flexure should be documented before group stratification in future trials of adjuvant chemotherapy in patients with stage II and III colon cancer.


2021 ◽  
Vol 81 ◽  
pp. 105759
Author(s):  
Khaled Arnaout ◽  
Nouran Hawa ◽  
Sarab Agha ◽  
Lama Kadoura ◽  
Marwa Aloulou ◽  
...  

2021 ◽  
pp. 102393
Author(s):  
El yamine othmane ◽  
Fatimazahra Bensardi ◽  
Abdessamad majd ◽  
El Bakouri Abdelilah ◽  
Bouali Mounir ◽  
...  

Author(s):  
Kosuke Mima ◽  
Nobutomo Miyanari ◽  
Keisuke Kosumi ◽  
Takuya Tajiri ◽  
Kosuke Kanemitsu ◽  
...  

2003 ◽  
Vol 83 (1) ◽  
pp. 58-66 ◽  
Author(s):  
Kelly E Pesanelli ◽  
Joseph A Cigna ◽  
Shantanu G Basu ◽  
Andrew R Morin

Abstract Background and Purpose. The purpose of this case report is to describe an occupational rehabilitation program for a person whose work-related inguinal hernia was surgically repaired. Case Description. A 35-year-old baggage service attendant acquired an inguinal hernia while lifting at work. Postoperatively, the patient had discomfort in the groin, weakness of the lower extremities and trunk, limited ability to walk, and a decreased ability to work due to impaired tolerance.Outcomes. Following postoperative rehabilitation, the patient was able to return to full-time, full-duty work. Discussion. This case report describes occupational rehabilitation as a method to treat patients with work-related inguinal hernias following surgical repair.


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