Unexplained neoplastic anastomotic recurrence after right hemicolectomy: a case report

Background Anastomotic recurrences of the colon are postulated to arise due to inadequate margins, tumor implantation by exfoliated cells, altered biological properties of bowel anastomosis, and missed synchronous lesions. In this paper, a case of unexpected early local recurrence after surgery for colon cancer is presented. Case presentation A 68-year-old Caucasian man underwent right hemicolectomy for invasive G2 adenocarcinoma. Two months later, endoscopy revealed a wide and well-functioning anastomosis with a hyperemic, hard, and thickened mucosal area of about 2 cm in diameter. Biopsies showed the presence of an adenocarcinoma with the same grading of the previous lesion. Ten days later, the patient underwent a new intervention; the last 10 cm of the ileum and half of the remaining transverse colon were resected, and the patient started adjuvant therapy. Specimen examination confirmed the presence of an adenocarcinoma (G2) penetrating the muscular layer of the wall; also, in this case, resection edges were free from tumoral invasion, and the removed lymph nodes were exempt from neoplastic colonization. The patient was seen in follow-up for about 5 years, and he did not show local or systemic manifestations. Conclusions Whenever a neoplastic recurrence on the anastomotic line occurs, in the presence of negative intestinal margins, as usual in right colectomies, the implantation of neoplastic cells could be the possible cause.

Use of Antioxidant Substances in Intestinal Anastomosis in Rats

Introduction: Intestinal anastomosis consist of surgical procedures which there is an anastomotic line between two intestinal segments in order to reconstruct or divert the digestive transit. However, several complications may result from this surgical procedure. Objective: Present, describe and discuss the findings of the literature regarding substances capable of reducing injury and possible complications of intestinal anastomoses. Method: The data were collected by literature review using the descriptors: "intestinal anastomoses", "antioxidants"; and as basis articles published in the published Scientific Electronic Library (Scielo), Lilacs, MedLine and Pubmed databases. Inclusion criteria were original and review articles published in full in the online form in the Portuguese, Spanish and English languages, using the descriptors mentioned above in the respective languages. Results: Scientific articles were collected, in which 38 papers were included in the inclusion criteria. Conclusions: The major parts of substances described in the present study demonstrated be statistically relevant results and the capacity to optimize the anastomotic healing.

Editorial on Hirten et al

The significance of ulcers confined to the anastomotic line in Crohn’s disease patients remains unclear.

Infected Anastomotic Pseudoaneurysm after Aortic Valve Replacement with Annular Enlargement

Anastomotic pseudoaneurysm remains one of the main life-threatening complications of cardiac and thoracic aorta surgery. We report a rare case of infected pseudoaneurysm at the anastomotic line found during follow-up. Blood culture results suggested Enterococcus faecium infection. Transthoracic echocardiography and computed tomography scans revealed the presence of a pseudoaneurysm of the ascending aorta. The pseudoaneurysm was resected and the ascending aorta was reconstructed with an artificial vascular patch without complications. Reducing the anastomotic tension, with complete hemostasis at the anastomotic incision, is the most important means of preventing the formation of pseudoaneurysm.