Intraperitoneal migrating mesh plug wrongfully taken for right colon cancer: A case report

Abstract Background The strategy for treating obstructive colon cancers with metastatic lesions remains unclear. Herein, we report a case of laparoscopic ileo-transverse colon bypass (LITB) before preoperative chemotherapy for an obstructive right colon cancer. Case presentation A 59-year-old woman was referred to our institution (Department of Gastroenterological Surgery, Chiba Cancer Center) for liver tumors detected on ultrasound. The clinical diagnosis was ascending colon cancer with multiple liver metastases. Based on the criteria of the International Union against Cancer Committee, 8th edition, the staging was confirmed as cT4aN1M1a(H), cStage IV. Although the primary tumor in the ascending colon extended beyond the colonic wall, curative resection was possible for both primary and metastatic tumors. We planned to administer chemotherapy before the radical surgery to obtain tumor-free resection margins; however, as the obstruction was fatal, LITB was prioritized and performed using five ports. An intracorporeal side-to-side anastomosis was performed between the ileum, 25 cm from the terminal ileum, and the transverse colon. The patient was discharged on postoperative day 18 without any complications. After LITB, for preoperative chemotherapy, five courses of capecitabine plus oxaliplatin (CapeOX) + bevacizumab were administered. Six weeks after the preoperative chemotherapy, right hemicolectomy with D3 lymph node dissection and right hepatectomy were performed. Pathological findings of the resected specimen confirmed curative resection of both lesions, and a favorable effect of chemotherapy was obtained. The patient has been alive for over 8 months after the surgery, with no evidence of cancer recurrence. Conclusions This case report demonstrates the effectiveness of LITB for obstructive right colon cancer in patients who need preoperative chemotherapy.

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Ovarian metastases from right colon cancer treated with systemic cancer chemotherapy, a case report

International Journal of Surgery Case Reports ◽

10.1016/j.ijscr.2018.04.017 ◽

2018 ◽

Vol 47 ◽

pp. 25-29 ◽

Cited By ~ 1

Author(s):

Paul H. Sugarbaker ◽

John Liang

Keyword(s):

Colon Cancer ◽

Case Report ◽

Cancer Chemotherapy ◽

Right Colon ◽

Ovarian Metastases ◽

Right Colon Cancer

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Duodenectomy with jejunal advancement and reimplantation of the ampulla of Vater for recurrent right colon cancer: A case report

International Journal of Surgery Case Reports ◽

10.1016/j.ijscr.2019.07.022 ◽

2019 ◽

Vol 62 ◽

pp. 1-4

Author(s):

Paul H. Sugarbaker

Keyword(s):

Colon Cancer ◽

Case Report ◽

Ampulla Of Vater ◽

Right Colon ◽

Right Colon Cancer

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Modified Complete Mesocolic Excision (mCME) for Right Colon Cancer

Case Medical Research ◽

10.31525/ct1-nct03992599 ◽

2019 ◽

Author(s):

Keyword(s):

Colon Cancer ◽

Complete Mesocolic Excision ◽

Right Colon ◽

Right Colon Cancer ◽

Mesocolic Excision

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A learning curve in using organ retractor for single-incision laparoscopic right colectomy

Scientific Reports ◽

10.1038/s41598-021-86168-4 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Toshio Shiraishi ◽

Tetsuro Tominaga ◽

Takashi Nonaka ◽

Kiyoaki Hamada ◽

Masato Araki ◽

...

Keyword(s):

Colon Cancer ◽

Laparoscopic Surgery ◽

Blood Loss ◽

Learning Curve ◽

Single Incision ◽

Operation Time ◽

Perioperative Outcomes ◽

Single Incision Laparoscopic Surgery ◽

Right Colon ◽

Right Colon Cancer

AbstractSingle-incision laparoscopic surgery (SILS) has the potential to improve perioperative outcomes, including less postoperative pain, shorter operation time, less blood loss, and shorter hospital stay. However, SILS is technically difficult and needs a longer learning curve. Between April 2016 and September 2019, a total of 198 patients with clinical stage I/II right colon cancer underwent curative resection. In the case of the SILS approach, an organ retractor was usually used to overcome SILS-specific restrictions. The patients were divided into two groups by surgical approach: the SILS with organ retractor group (SILS-O, n = 33) and the conventional laparoscopic surgery group (LAC, n = 165). Clinical T status was significantly higher in the LAC group (p = 0.016). Operation time was shorter and blood loss was lower in the SILS-O group compared to the LAC group (117 vs. 197 min, p = 0.027; 10 vs. 25 mL, p = 0.024, respectively). In the SILS-O group, surgical outcomes including operation time, blood loss, number of retrieved lymph nodes, and postoperative complications were not significantly different between those performed by experts and by non-experts. Longer operation time (p = 0.041) was significantly associated with complications on univariate and multivariate analyses (odds ratio 2.514, 95%CI 1.047–6.035, p = 0.039). SILS-O was safe and feasible for right colon cancer. There is a potential to shorten the learning curve of SILS using an organ retractor.

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Comparison of postoperative recovery of patients who underwent laparoscopic-assisted radical resection of right colon cancer with modified triangular anastomosis or tubular anastomosis: a retrospective cohort study

BMC Surgery ◽

10.1186/s12893-021-01086-6 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Tianfang Xia ◽

Zhenguo Pan ◽

Jie Zhang ◽

Guo Xu

Keyword(s):

Colon Cancer ◽

Digestive Tract ◽

Transverse Colon ◽

Retrospective Cohort ◽

Radical Resection ◽

Anastomosis Group ◽

Group Differences ◽

Right Colon ◽

Right Colon Cancer ◽

Laparoscopic Assisted

Abstract Background We compared the advantages and disadvantages of modified triangular anastomosis and tubular anastomosis for digestive tract reconstruction in patients undergoing laparoscopic-assisted radical resection of right colon cancer. Methods This was a retrospective cohort analysis of 92 cases of laparoscopic-assisted resection of right colon cancer, treated from June 2017 to June 2018, at the Huai’an No. 1 People’s Hospital in China. Patients were divided into a modified triangular anastomosis group (n = 33) and a tubular anastomosis group (n = 59). In the modified triangular anastomosis group, digestive tract reconstruction was conducted using side-to-side anastomosis of the ileo-transverse colon with a 60-mm linear stapler. The common entry hole was closed with a running suture. The tubular anastomosis group underwent end-to-side anastomosis of the ileo-transverse colon with a tubular stapler anchor placed at the end of the ileum. Results At baseline and perioperatively, there were no significant between-group differences in age, sex, body mass index, tumor location, pathological stage, or tumour size (P > 0.05). There were also no significant between-group differences in operation time, estimated blood loss, the number of harvested lymph nodes, the first postoperative flatulence time, hospitalisation time, or postoperative complications (P > 0.05); however, the total cost of hospitalization for the triangular anastomosis group was significantly lower than the tubular anastomosis group (P < 0.05). Conclusion Modified triangular anastomosis is a safe and feasible procedure for laparoscopic-assisted radical resection of right colon cancer. These results affirm the safety and effectiveness of total laparoscopic radical resection of right colon cancer. Given the equivalent outcomes between the two procedures, the modified triangular procedure may be more a more cost-effective option for clinical application.

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