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Journal of Visceral Surgery Dec 2021
Topics: Adrenalectomy; Humans; Laparoscopy; Peritoneum
PubMed: 33994133
DOI: 10.1016/j.jviscsurg.2021.05.002 -
Radiologic Clinics of North America Sep 2014The development of colorectal cancer screening programs in many countries has led to increasingly large numbers of patients undergoing optical colonoscopy. Although... (Review)
Review
The development of colorectal cancer screening programs in many countries has led to increasingly large numbers of patients undergoing optical colonoscopy. Although acute complications from screening optical colonoscopy are uncommon, they may occur in up to 5% or more of patients where biopsies or therapeutic procedures are performed. Abdominal radiographs are of value only for the detection of intraperitoneal perforation. There is a wide spectrum of other important associated complications. Such complications are most reliably identified using abdominal and pelvic CT, which also can guide appropriate conservative, interventional, or surgical management.
Topics: Colonography, Computed Tomographic; Colonoscopy; Hemorrhage; Humans; Intestinal Diseases; Peritoneum; Spleen
PubMed: 25173660
DOI: 10.1016/j.rcl.2014.05.012 -
Journal of Minimally Invasive Gynecology May 2023Deep endometriotic lesions may involve the deep parametrium, which is highly vascular and includes numerous somatic and autonomous nerves [1,2]. Surgeons who dissect in...
STUDY OBJECTIVE
Deep endometriotic lesions may involve the deep parametrium, which is highly vascular and includes numerous somatic and autonomous nerves [1,2]. Surgeons who dissect in this area must always be prepared to deal with major bleeding and to master the different techniques of hemostasis. The goal of this video is to show the steps of laparoscopic excision of deep endometriotic lesion of the parametrium and the steps taken to control the bleeding encountered from one of the venous branches.
DESIGN
Surgical educational video.
SETTING
Endometriosis referral center.
INTERVENTIONS
Excision of the endometriotic parametrial nodule and the release of the sacral plexus, with excision of the vaginal involvement, rectal disc excision, and segmental resection of the sigmoid colon. The video shows the excision of a deep endometriosis involving the right parametrium, mid rectum, sigmoid colon, and vagina. The excision of deep endometriosis of the parametrium followed the 10 steps previously described [1]. During this procedure, careful dissection of arteries and veins branching from the internal iliac vessels is a crucial step. However, injury of one or more of the vessels can still occur. The video presents the different techniques used to control the bleeding from a venous injury faced during the dissection around the nodule in the parametrium, including energy use, clips, hem-o-loks, and direct continuous pressure. Of note, hemostatic agents are available; however, we have not yet successfully used them in the circumstances in which large veins were injured. The ultimate solution in our case was the clamping of the injured vessels, allowing meticulous dissection and sectioning of all the feeding vessels, while taking care not to injure the sacral roots that were just beneath these veins. Total operative time was 4 hours.
CONCLUSION
Surgery of deep endometriosis involving the sacral plexus may be successfully done laparoscopically. Thorough knowledge of the deep pelvis anatomy is mandatory, and the surgeon should master various techniques of hemostasis, particularly on deep veins.
Topics: Female; Humans; Rectum; Colon, Sigmoid; Peritoneum; Endometriosis; Pelvis; Laparoscopy; Vagina; Rectal Diseases
PubMed: 36764650
DOI: 10.1016/j.jmig.2023.02.003 -
Peritoneal Dialysis International :... Mar 2020Peritoneal dialysis (PD) accounts for approximately 10% of the dialysis population worldwide. Major concern limiting long-term PD success is the loss of the peritoneal... (Review)
Review
Peritoneal dialysis (PD) accounts for approximately 10% of the dialysis population worldwide. Major concern limiting long-term PD success is the loss of the peritoneal membrane function after prolonged exposure to dialysis solutions. The complement system is a major component of the innate immune system, which provides a first-line defense against pathogens. Uncontrolled activation of the complement system directly contributes to the pathophysiology of rare and common kidney diseases and to a growing number of nonrenal diseases. Here, we review currently available evidence of complement activation in patients treated with PD and its association with structural and functional alterations of the peritoneal membrane. Mainly, evidence point toward a local, intraperitoneal, production of complement molecules in response to PD exposure. Dialysis fluids, particularly glucose, play a role in complement activation and dysregulation leading to untoward PD-related pathophysiological processes such as peritoneal fibrosis, angiogenesis, and vasculopathy and, perhaps, encapsulating peritoneal fibrosis development. These findings could lead to further development and use of anticomplement therapeutics in PD patients to prevent membrane damage.
Topics: Complement Activation; Dialysis Solutions; Glucose; Humans; Peritoneal Dialysis; Peritoneal Fibrosis; Peritoneum
PubMed: 32063185
DOI: 10.1177/0896860819896242 -
Cells, Tissues, Organs 2017There are several pathologies associated with the peritoneum, such as mesothelioma and peritonitis. Moreover, the peritoneum is widely used in ultrafiltration... (Review)
Review
There are several pathologies associated with the peritoneum, such as mesothelioma and peritonitis. Moreover, the peritoneum is widely used in ultrafiltration procedures, i.e., peritoneal dialysis, presenting advantages over hemodialysis. On the other hand, ultrafiltration failure may lead to dialysis-induced fibrosis and hypervolemia. Therefore, the pathophysiological study of this tissue is of extreme biomedical importance. Studies investigating the biology of the cells dwelling in the peritoneum wall provide evidence of their plasticity and progenitor features. For instance, both mesothelial and submesothelial cells present characteristics similar to mesenchymal stem cells, including osteogenic and adipogenic differentiation potential, support of extramedullary hematopoiesis, modulation of inflammatory responses, and regulation of tumor progression. Indeed, the participation of each cell type in peritoneal pathological and physiological phenomena is still under debate, especially regarding a possible differentiation pathway connecting these peritoneal cells. The primary aim of this review is to raise this discussion. In order to do so, we will firstly provide an overview of the peritoneum anatomy, histology, and ontology, and finally we will address how a better understanding of peritoneal cell biology may contribute to future cell therapy and tissue engineering approaches.
Topics: Animals; Cell- and Tissue-Based Therapy; Fibrosis; Humans; Mesothelioma; Peritoneum; Peritonitis; Stem Cell Transplantation; Stem Cells; Tissue Engineering
PubMed: 28972947
DOI: 10.1159/000479924 -
Zhonghua Wei Chang Wai Ke Za Zhi =... Jul 2023The theory of membrane anatomy has been widely used in the field of colorectal surgery. The key point to perform high quality total mesorectal excision (TME) and...
The theory of membrane anatomy has been widely used in the field of colorectal surgery. The key point to perform high quality total mesorectal excision (TME) and complete mesocolic excision (CME) is to identify the correct anatomical plane. Intraoperative identification of the various fasciae and fascial spaces is the key to accessing the correct surgical plane and surgical success. The landmark vessels refer to the small vessels that originate from the original peritoneum on the surface of the abdominal viscera during embryonic development and are produced by the fusion of the fascial space. From the point of view of embryonic development, the abdominopelvic fascial structure is a continuous unit, and the landmark vessels on its surface do not change morphologically with the fusion of fasciae and have a specific pattern. Drawing on previous literature and clinical surgical observations, we believe that tiny vessels could be used to identify various fused fasciae and anatomical planes. This is a specific example of membrane anatomical surgery.
Topics: Humans; Mesentery; Colonic Neoplasms; Colorectal Surgery; Digestive System Surgical Procedures; Peritoneum; Rectal Neoplasms; Laparoscopy
PubMed: 37583023
DOI: 10.3760/cma.j.cn441530-20230323-00091 -
Peritoneal Dialysis International :... Mar 2023
Topics: Humans; Biological Transport; Dialysis Solutions; Glucose; Peritoneal Dialysis; Peritoneum; Sodium-Glucose Transporter 2 Inhibitors
PubMed: 37013683
DOI: 10.1177/08968608231161178 -
Frontiers in Immunology 2023Ovarian cancer metastasis occurs primarily in the peritoneal cavity. Orchestration of cancer cells with various cell types, particularly macrophages, in the peritoneal... (Review)
Review
Ovarian cancer metastasis occurs primarily in the peritoneal cavity. Orchestration of cancer cells with various cell types, particularly macrophages, in the peritoneal cavity creates a metastasis-favorable environment. In the past decade, macrophage heterogeneities in different organs as well as their diverse roles in tumor settings have been an emerging field. This review highlights the unique microenvironment of the peritoneal cavity, consisting of the peritoneal fluid, peritoneum, and omentum, as well as their own resident macrophage populations. Contributions of resident macrophages in ovarian cancer metastasis are summarized; potential therapeutic strategies by targeting such cells are discussed. A better understanding of the immunological microenvironment in the peritoneal cavity will provide a stepping-stone to new strategies for developing macrophage-based therapies and is a key step toward the unattainable eradication of intraperitoneal metastasis of ovarian cancer.
Topics: Humans; Female; Peritoneal Cavity; Ovarian Neoplasms; Peritoneum; Omentum; Macrophages; Tumor Microenvironment
PubMed: 37180125
DOI: 10.3389/fimmu.2023.1104694 -
Molecular Oncology Jan 2024Peritoneal dissemination of cancer affects patient survival. The behavior of peritoneal mesothelial cells (PMCs) and immune cells influences the establishment of a...
Peritoneal dissemination of cancer affects patient survival. The behavior of peritoneal mesothelial cells (PMCs) and immune cells influences the establishment of a microenvironment that promotes cancer cell metastasis in the peritoneum. Here, we investigated the roles of lactosylceramide alpha-2,3-sialyltransferase (ST3G5; also known as ST3GAL5 and GM3 synthase) in the exosome-mediated premetastatic niche in peritoneal milky spots (MSs). Exosomes secreted from ST3G5 cancer cells (ST3G5 -cExos) were found to contain high levels of hypoxia-inducible factor 1-alpha (HIF1α) and accumulated in MSs via uptake in macrophages (MΦs) owing to increased expression of sialic acid-binding Ig-like lectin 1 (CD169; also known as SIGLEC1). ST3G5 -cExos induced pro-inflammatory cytokines and glucose metabolic changes in MΦs, and the interaction of these MΦs with PMCs promoted mesothelial-mesenchymal transition (MMT) in PMCs, thereby generating αSMA myofibroblasts. ST3G5 -cExos also increased the expression of immune checkpoint molecules and T-cell exhaustion in MSs, which accelerated metastasis to the omentum. These events were prevented following ST3G5 depletion in cancer cells. Mechanistically, ST3G5 -cExos upregulated chemokines, including CC-chemokine ligand 5 (CCL5), in recipient MΦs and dendritic cells (DCs), which induced MMT and immunosuppression via activation of signal transducer and activator of transcription 3 (STAT3). Maraviroc, a C-C chemokine receptor type 5 (CCR5) antagonist, prevented ST3G5 -cExo-mediated MMT, T-cell suppression, and metastasis in MSs. Our results suggest ST3G5 as a suitable therapeutic target for preventing cExo-mediated peritoneal dissemination.
Topics: Humans; Peritoneum; Exosomes; Cell Communication; Biological Transport; Neoplasms
PubMed: 37716915
DOI: 10.1002/1878-0261.13524 -
Abdominal Imaging Feb 2015Peritoneal disease can be caused by a wide spectrum of pathologies. While peritoneal disease is usually caused by primary or secondary malignancies, benign diseases can... (Review)
Review
Peritoneal disease can be caused by a wide spectrum of pathologies. While peritoneal disease is usually caused by primary or secondary malignancies, benign diseases can occur and mimic malignancies. This article begins with an overview of peritoneal embryology and anatomy followed by a detailed description of the multimodality imaging appearance of peritoneal diseases. Common diseases include peritoneal carcinomatosis, pseudomyxoma peritonei, lymphomatosis, sarcomatosis, and tuberculous peritonitis. The uncommon diseases which cause peritoneal disease include desmoid fibromatosis, desmoplastic small round cell tumor, malignant mesothelioma, well-differentiated mesothelioma, multicystic mesothelioma, papillary serous carcinoma, leiomyomatosis, extramedullary hematopoiesis, inflammatory pseudotumor and amyloidosis. This manuscript will help the radiologist become familiar with the different peritoneal spaces, pathways of spread, multimodality imaging appearance and differential diagnoses of peritoneal diseases in order to report the essential information for surgeons and oncologists to plan treatment.
Topics: Contrast Media; Diagnosis, Differential; Humans; Image Enhancement; Magnetic Resonance Imaging; Multimodal Imaging; Peritoneal Diseases; Peritoneal Neoplasms; Peritoneum; Positron-Emission Tomography; Tomography, X-Ray Computed
PubMed: 25139643
DOI: 10.1007/s00261-014-0224-8