scholarly journals Pristine Normal Looking Appendix on Diagnostic Laparoscopy-A Management Dilemma

Author(s):  
Sarathy Kasturi Rangan ◽  
Samee Abdus
2012 ◽  
Vol 2 (7) ◽  
pp. 290-292
Author(s):  
Dr Vandana K Saini ◽  
◽  
Dr Sachin C Patel ◽  
Dr Kishor Kawad

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
M. P. Engbersen ◽  
C. J. V. Rijsemus ◽  
J. Nederend ◽  
A. G. J. Aalbers ◽  
I. H. J. T. de Hingh ◽  
...  

Abstract Background Selecting patients with peritoneal metastases from colorectal cancer (CRCPM) who might benefit from cytoreductive surgery followed by hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) is challenging. Computed tomography generally underestimates the peritoneal tumor load. Diagnostic laparoscopy is often used to determine whether patients are amenable for surgery. Magnetic resonance imaging (MRI) has shown to be accurate in predicting completeness of CRS. The aim of this study is to determine whether MRI can effectively reduce the need for surgical staging. Methods The study is designed as a multicenter randomized controlled trial (RCT) of colorectal cancer patients who are deemed eligible for CRS-HIPEC after conventional CT staging. Patients are randomly assigned to either MRI based staging (arm A) or to standard surgical staging with or without laparoscopy (arm B). In arm A, MRI assessment will determine whether patients are eligible for CRS-HIPEC. In borderline cases, an additional diagnostic laparoscopy is advised. The primary outcome is the number of unnecessary surgical procedures in both arms defined as: all surgeries in patients with definitely inoperable disease (PCI > 24) or explorative surgeries in patients with limited disease (PCI < 15). Secondary outcomes include correlations between surgical findings and MRI findings, cost-effectiveness, and quality of life (QOL) analysis. Conclusion This randomized trial determines whether MRI can effectively replace surgical staging in patients with CRCPM considered for CRS-HIPEC. Trial registration Registered in the clinical trials registry of U.S. National Library of Medicine under NCT04231175.


Author(s):  
Joseph I. Ikechebelu ◽  
George U. Eleje ◽  
Ngozi N. Joe-Ikechebelu ◽  
Chidimma Donatus Okafor ◽  
Boniface Chukwuneme Okpala ◽  
...  

Author(s):  
R. Taylor Ripley ◽  
Nihanth Palivela ◽  
Shawn S. Groth ◽  
Eugene A. Choi ◽  
Lorraine D. Cornwell ◽  
...  

2021 ◽  
pp. 000313482110474
Author(s):  
Ahmad Kharsa ◽  
Kayla Colvill ◽  
Heather Stevenson ◽  
Jeffrey Fair ◽  
Rupak Kulkarni ◽  
...  

Despite its numerous benefits, peritoneal dialysis (PD) can rarely result in dangerous and even life-threatening complications, including peritonitis, hernias, encapsulating peritoneal sclerosis (EPS), and rarely peritoneal pseudocysts. Herein, we present a rare case of a giant intra-peritoneal pseudocyst that presented four months following the discontinuation of a 5-year course of complicated PD. Despite the initially successful drainages, the patient’s symptoms continued to recur, and the imaging findings were concerning for underlying neoplastic processes. As such, a staged surgical approach was performed, starting with a diagnostic laparoscopy and was subsequently followed with cyst excision and marsupialization to the peritoneal cavity. While previous reports of such rare pseudocyst have been documented in the literature as a complication of PD, to our knowledge, this is the second case of pseudocyst formation to occur months after the discontinuation of PD therapy. This case emphasizes the importance of close follow-up in PD patients and showcases how a staged surgical approach can be utilized to accurately diagnose and manage such complicated cases.


1999 ◽  
Vol 86 (7) ◽  
pp. 951-955 ◽  
Author(s):  
K. T. den Boer ◽  
L. T. de Wit ◽  
J. Dankelman ◽  
D. J. Gouma

Author(s):  
Manjula Anagani ◽  
Prabha Agrawal ◽  
B. Radhika ◽  
Amodita Ahuja

A 30-year-old woman presented with dyspareunia and infertility and was referred to after failure to visualize cervix during diagnostic laparoscopy by her primary consultant. Preoperative MRI was done which showed mild arcuate uterus with minimum fluid in vaginal cavity with vertical vaginal septum. This was managed successfully by a combined laparoscopic and vaginal approach. She conceived spontaneously and delivered a healthy term baby by caesarean section. Upper thick Transverse Vaginal Septum is a complex congenital malformation posing challenges for its correction, restoring normal healthy sex life and conception. The septum varies in thickness and may be located anywhere along the vagina reducing the functional length of the vagina.  Identifying and dissecting the anatomic structures is greatly aided by panoramic view of laparoscope allowing the surgeon to have an increased degree of freedom during surgery.


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