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Annals of Gastroenterological Surgery Jan 2021Transverse colon, owing its origin to midgut and hindgut and harbouring a flexure at both ends, continues to pose a surgical challenge. When compared to the rest of the...
Transverse colon, owing its origin to midgut and hindgut and harbouring a flexure at both ends, continues to pose a surgical challenge. When compared to the rest of the colon, transverse colon adenocarcinoma is relatively uncommon. These cancers usually present late and lie in close proximity to the stomach, omentum, and pancreas. Adequate lymphadenectomy entails dissection around and ligation of the middle colic vessels. Hence, resectional surgery for transverse colon carcinoma is considered difficult. This is more so because of the variation of arterial and venous anatomy. From this perspective, the surgeon is tempted to perform a more radical operation like extended right or left hemicolectomy to secure an adequate lymphadenectomy. Such a cancer has also been dealt with a more limited transverse colectomy with colo-colic anastomosis. For all these reasons, patients with transverse colon adenocarcinoma were excluded from randomised trials which compared laparoscopic resection with traditional open operation. Surgical literature is yet to establish a definite operation for transverse colon cancer and the exact procedure is often dictated by surgeon's preference. This is primarily because this is an uncommon cancer. The rapid adoption of laparoscopic operation favoured extended colectomy as transverse colectomy can be difficult by minimally invasive technique. However, in the recent past, cohort studies and meta-analyses have shown equivalent oncological outcome between transverse colectomy and extended colectomy. It is time to resurrect transverse colectomy and consider it equivalent to its radical counterpart for cancers around the mid-transverse colon.
PubMed: 33532677
DOI: 10.1002/ags3.12380 -
International Journal of Surgery Case... 2018Nowadays, after wide left colectomy, it is necessary to choose one of the following procedures: a definitive transverse colostomy, an ileo-rectal anastomosis or a right...
INTRODUCTION
Nowadays, after wide left colectomy, it is necessary to choose one of the following procedures: a definitive transverse colostomy, an ileo-rectal anastomosis or a right colo-rectal anastomosis (Deloyers procedure).
PRESENTATION OF CASE
We performed our new procedure on a 63 years-old man. After an extensive left proctocolectomy, the intestinal continuity between the transverse colon and rectum was obtained by transposition and rotation of the right colon into the pelvis. After recanalization the patient never lost the functions of the large intestine and progressively restored continence.
DISCUSSION
Saving the transverse colon and the right colon mean achieving not only continence but also a better degree of reabsorption of liquids and vitamin K and group B production in order to keep intestinal functions as similar as possible to the normal physiology.
CONCLUSION
The one-year follow-up surgical and clinical outcomes are encouraging to support the feasibility of this procedure in terms of improving the quality of life: avoiding diarrhea, incontinence and post-operative urgency.
PubMed: 29778632
DOI: 10.1016/j.ijscr.2018.04.015 -
BMC Surgery May 2021Robot-assisted laparoscopic transverse colon tumor surgery requires precise tumor localization. The purpose of this study was to evaluate the safety and efficacy of...
BACKGROUND
Robot-assisted laparoscopic transverse colon tumor surgery requires precise tumor localization. The purpose of this study was to evaluate the safety and efficacy of nano-carbon and titanium clip combination labeling methods in robot-assisted transverse colon tumor surgery.
METHODS
From January 2018 to January 2019, the clinical data of 16 patients who come from FuZhou, China underwent preoperative nano-carbon and titanium clip combined with robot-assisted laparoscopic transverse colon cancer surgery were retrospectively analyzed.
RESULTS
Of the 16 patients, no signs of abdominal pain, fever, or diarrhea were observed after colonoscopy. Two titanium clips were seen on all of the 16 patients' abdominal plain films. Nano-carbon staining sites were observed during the operation, and no staining disappeared or abdominal cavity contamination. All patients underwent R resection. The average number of lymph nodes harvsted was 18.23 ± 5.04 (range, 9-32). The average time to locate the lesion under the laparoscopic was 3.03 ± 1.26 min (range, 1-6 min), and the average operation time was 321.43 ± 49.23 min (range, 240-400 min). All were consistent with the surgical plan, and there was no intraoperative change of surgical procedure or conversion to open surgery.
CONCLUSION
Preoperative colonoscopy combined with nano-carbon and titanium clip is safe and effective in robot-assisted transverse colon cancer surgery. A At the same time, the labeling method shows potential in shortening the operation time, ensuring sufficient safety margin and reducing complications.
Topics: Carbon; China; Colon, Transverse; Humans; Laparoscopy; Neoplasms; Retrospective Studies; Robotics; Surgical Instruments; Titanium; Treatment Outcome
PubMed: 34030673
DOI: 10.1186/s12893-021-01248-6 -
Journal of Surgical Case Reports Dec 2023Schwannomas of the gastrointestinal tract are rare spindle cell tumors that account for 2-6% of mesenchymal tumors. An elderly male was found to have a left colon mass...
Schwannomas of the gastrointestinal tract are rare spindle cell tumors that account for 2-6% of mesenchymal tumors. An elderly male was found to have a left colon mass on CT scan and colonoscopy with pathology of fibrotic tissue. A laparoscopic-assisted left hemi-colectomy with primary anastomosis was performed. Pathology demonstrated spindle cell neoplasm arranged in short fascicles that were strongly and diffusely positive for S100. An elderly female was found to have a submucosal lesion on surveillance colonoscopy in the proximal transverse colon. Biopsy with jumbo forceps revealed spindle cell neoplasm positive for S100. Patient underwent an uncomplicated limited non-oncologic segmental transverse colectomy. We report only the ninth case of left and sixth in the transverse colon described in the literature. As is true for other mesenchymal tumors, mucosal biopsy is usually inconclusive and deep biopsy or submucosal resection is required, making pre-operative surgical decision difficult.
PubMed: 38163055
DOI: 10.1093/jscr/rjac438 -
African Journal of Paediatric Surgery :... 2021Duplication cysts of gastrointestinal tract are rare congenital abnormalities found in 0.2% of children. We report a rare case of a ruptured duplication cyst of...
Duplication cysts of gastrointestinal tract are rare congenital abnormalities found in 0.2% of children. We report a rare case of a ruptured duplication cyst of transverse colon in a 7-year-old female child who presented with abdominal pain and mass in the right iliac fossa. We assumed it as an appendicular mass; however, it turned out to be a ruptured duplication cyst of transverse colon. Only two cases of duplication cyst of transverse colon have been reported yet in the literature.
Topics: Appendix; Child; Colon, Transverse; Cysts; Female; Humans; Rupture, Spontaneous
PubMed: 33642411
DOI: 10.4103/ajps.AJPS_81_20 -
Cureus May 2023Intestinal intussusception rarely occurs in adults and is challenging to diagnose in the emergency department due to its associated nonspecific symptom of abdominal...
Intestinal intussusception rarely occurs in adults and is challenging to diagnose in the emergency department due to its associated nonspecific symptom of abdominal pain. Most of these incidences are caused by a neoplasm within the bowel acting as a lead point. Lipomas are benign fatty tumors that rarely develop in the colon and are very infrequently a precursor lesion to intussusception. Our present report describes a case of lipoma-associated intussusception in the transverse colon in an adult who presented with complaints of abdominal pain and acutely worsened chronic constipation. Computerized tomography (CT) imaging and barium enema revealed colocolonic intussusception with a lipomatous lead point and complete obstruction. The patient was admitted for same-day intervention and underwent a successful colectomy with no complications.
PubMed: 37288201
DOI: 10.7759/cureus.38671 -
Cureus Dec 2021Volvulus of the colon is the third important reason for colon obstruction, which can occur in different parts of the colon for various reasons and can lead to ischemia...
Volvulus of the colon is the third important reason for colon obstruction, which can occur in different parts of the colon for various reasons and can lead to ischemia and necrosis of the colon wall tissue. In this article, we are going to describe a simultaneous sigmoid and colon volvulus which was operated on with suspicion of sigmoid volvulus. A 72-year-old patient presented with suddenly severe generalized abdominal pain with a past medical history of inflammatory bowel disease (IBD) and prolonged constipation who underwent laparotomy for suspected colonic volvulus. During the operation, it was found that transverse colon volvulus occurred simultaneously with sigmoid colon volvulus with colon necrosis along its length. Therefore, a total colectomy with ileorectal anastomosis was performed. After one week, the patient was discharged from the surgical ward after tolerating feeding and with stable vital signs. The simultaneous transverse colon and sigmoid volvulus is a rare phenomenon, and there are several ways to diagnose and evaluate this situation. However, none of them can help us diagnose this disease. Unfortunately, no specific algorithm has been designed for the approach in this situation, and it all depends on the patient's condition. Simultaneous occurrence of the sigmoid and transverse colon can make a high-risk emergency condition that could threaten the patient's life. Therefore, paying attention to the patient's symptoms and patient's condition and clinical findings, with high accuracy and speed and subsequently selecting the best surgical technique, if surgery is necessary, and according to the finding during surgery, especially the extent of necrotic tissue, the most crucial issue in treating the patient.
PubMed: 35004061
DOI: 10.7759/cureus.20250 -
Frontiers in Surgery 2022The mid-transverse colon cancer is relatively uncommon in all colon cancers and the optimal surgical approach of mid-transverse colon cancer remains debatable.
INTRODUCTION
The mid-transverse colon cancer is relatively uncommon in all colon cancers and the optimal surgical approach of mid-transverse colon cancer remains debatable.
AIM AND OBJECTIVES
Our study aimed to depict the techniques and outcomes of laparoscopic transverse colectomy in one single clinical center and compare this surgical approach to traditional laparoscopic right hemicolectomy and laparoscopic left hemicolectomy.
METHOD
This was a retrospective cohort study of patients with mid-transverse colon cancer in one single clinical center from February 2012 to October 2020. The enrolled patients were divided into two groups undergoing laparoscopic transverse colectomy and laparoscopic right/left hemicolectomy, respectively. The intraoperative, postoperative complications, oncological outcomes and functional outcomes were compared between the two groups. The primary endpoint was disease free survival (DFS).
RESULTS
The study enrolled 70 patients with 40 patients undergoing laparoscopic transverse colectomy and 30 patients undergoing laparoscopic hemicolectomy. The intraoperative accidental hemorrhage and multiple organ resection occurred similarly in the two groups. In transverse colectomy, caudal-to-cephalic approach was likely to harvest more lymph nodes although require more operation time than cephalic-to-caudal approach (23.1 ± 14.3 vs. 13.4 ± 5.4 lymph nodes, = 0.004; 184.3 ± 37.1 min vs. 146.3 ± 44.4 min, = 0.012). The laparoscopic transverse colectomy was marginally associated with lower incidence of overall postoperative complications and shorter postoperative hospital stay although without statistical significance (8(20.0%) vs. 12(40.0%), = 0.067; 7(5-12) vs. 7(5-18), = 0.060). The 3-year DFS showed no significant difference (3-year DFS 89.7% in transverse colectomy vs. 89.9% in hemicolectomy, = 0.688) between the two groups. The alternating consistency of defecation occurred significantly less after laparoscopic transverse colectomy than laparoscopic hemicolectomy (15(51.7%) vs. 20(80.0%), = 0.030).
CONCLUSION
The laparoscopic transverse colectomy is technically feasible with satisfactory oncological and functional outcomes for mid-transverse colon cancer. Performing the caudal-to-cephalic approach might be more advantageous in lymphadenectomy.
PubMed: 36684238
DOI: 10.3389/fsurg.2022.1012947 -
Frontiers in Oncology 2023Duplication of the transverse colon is a rare gastrointestinal malformation. Its pathogenesis is still unclear, and it is extremely rare in adults. Patients often...
BACKGROUND
Duplication of the transverse colon is a rare gastrointestinal malformation. Its pathogenesis is still unclear, and it is extremely rare in adults. Patients often present with symptoms of tumor compression such as abdominal mass, abdominal pain, and constipation as the first manifestation.
METHODS AND RESULT
A patient with a duplication of the transverse colon was admitted to the Department of General Surgery of our hospital. Laparoscopic exploration found a mass at the rear of the transverse colon near the splenic flexure, and the root was connected to the middle portion of the transverse colon.
CONCLUSION
Surgery is a radical treatment and reduces the possibility of perforation, bleeding, obstruction, and cancer.
PubMed: 37731646
DOI: 10.3389/fonc.2023.1230860 -
Cureus Jun 2021Benign proliferations of smooth muscle cells are known as leiomyomas; these proliferations can occur in the colon and are typically found incidentally. Colonic...
Benign proliferations of smooth muscle cells are known as leiomyomas; these proliferations can occur in the colon and are typically found incidentally. Colonic leiomyomas are very rare and are most commonly found in the descending or sigmoid colon. A 59-year-old Hispanic female presented to the gastroenterology clinic for surveillance colonoscopy. The biopsy showed a submucosal microscopic leiomyoma in the transverse colon. The treatment of choice for most colonic leiomyomas is surgical excision. This rare case favors the notion that endoscopic polypectomy may be superior to surgical excision, ultimately providing a less-invasive and less-costly procedure without complications or recurrence.
PubMed: 34268053
DOI: 10.7759/cureus.15535