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1.
In Vivo ; 36(1): 522-527, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-34972757

RESUMO

BACKGROUND: Breast cancer often metastasizes to the lungs, bones, liver, and brain, colon metastasis from breast cancer (CMBC) is extremely rare. CASE REPORT: The patient was a 63-year-old female. Mastectomy had been performed for breast cancer (pStage IIB) 15 years earlier at another hospital. Metastasis to the lumbar spine had been detected 4 years prior to referral to us and the patient had undergone hormonal therapy with an aromatase inhibitor. Furthermore, early primary sigmoid colon cancer had been endoscopically resected 2 years before referral. The patient was diagnosed with cancer recurrence in the colon at follow-up examinations performed 2 years after that endoscopic resection. After referral to our hospital, laparoscopic sigmoidectomy was performed. Based on the histopathological examination and immunohistological staining results (positive for cytokeratin 7, GATA-binding protein 3, estrogen receptor and human epidermal growth factor receptor-related 2 (2+); negative for cytokeratin 20, progesterone receptor, E-cadherin, gross cystic disease fluid protein 15 and caudal-related homeobox 2) the final pathological diagnosis was CMBC. CONCLUSION: Although extremely rare, the possibility of CMBC should be considered in the case of colonic tumors in patients with a history of breast cancer.


Assuntos
Neoplasias da Mama , Neoplasias do Colo Sigmoide , Neoplasias da Mama/cirurgia , Colo Sigmoide , Feminino , Humanos , Mastectomia , Pessoa de Meia-Idade , Recidiva Local de Neoplasia , Neoplasias do Colo Sigmoide/cirurgia
2.
JNMA J Nepal Med Assoc ; 59(234): 204-206, 2021 Feb 28.
Artigo em Inglês | MEDLINE | ID: mdl-34506464

RESUMO

Colon carcinoma spreads locally around the intestine wall and can undergo distant metastasis via the hematogenous or lymphatic spread. It rarely metastasizes to the female genital tract and is not fully reported to involve a uterine leiomyoma. Herein we report such an unusual case of a 27 years female a known case of sigmoid colon adenocarcinoma who presented with abdominal pain with bilateral adnexal mass and per vaginal bleeding. Exploratory laparotomy with bilateral resection of ovaries with subsequent polypectomy was done, which on histopathology, it revealed metastatic adenocarcinoma in bilateral ovaries and submucosal leiomyoma. Hence, a lesion with dimorphic histomorphology should be carefully evaluated to rule out the possibility of malignant-to-benign tumor-to-tumor metastasis.


Assuntos
Adenocarcinoma , Leiomioma , Neoplasias do Colo Sigmoide , Adenocarcinoma/cirurgia , Adulto , Feminino , Humanos , Laparotomia , Leiomioma/cirurgia , Neoplasias do Colo Sigmoide/cirurgia
3.
Gan To Kagaku Ryoho ; 48(6): 833-836, 2021 Jun.
Artigo em Japonês | MEDLINE | ID: mdl-34139734

RESUMO

A 72-year-old woman underwent sigmoid colon resection plus D2 lymph node dissection in 2008, with additional resection after endoscopic mucosal resection(EMR). Histopathological examination revealed only atypical ducts in the EMR scar, with no invasion below the submucosa. No lymphatic, venous, or nerve invasions were confirmed, and oral and anal stumps and lymph node metastases were negative. She was followed up for 5 years after the surgery, and no recurrence was detected. In 2018, she visited our hospital with the chief complaint of diarrhea and constipation. Colonoscopy revealed a circumferential lesion around the anastomosis. She underwent laparoscopic low anterior resection for suspected anastomotic recurrence, which was confirmed by histopathological diagnosis. The anastomotic recurrence 10 years after surgery for SM cancer of the colon with negative lymph node metastasis and vascular factor was extremely rare. We recognized the importance of surveillance 5 years after surgery.


Assuntos
Neoplasias do Colo Sigmoide , Idoso , Anastomose Cirúrgica , Feminino , Humanos , Excisão de Linfonodo , Metástase Linfática , Recidiva Local de Neoplasia/cirurgia , Neoplasias do Colo Sigmoide/cirurgia
4.
Colorectal Dis ; 23(8): 2030-2040, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-33974325

RESUMO

AIM: Objective and reproducible quality measures of complete mesocolic excision (CME) for colon cancer are not currently available. This study aimed to measure the inferior mesenteric stump length following CME for sigmoid colon cancer and explore surgical, pathological and oncological outcomes in patients with a stump length of <10 mm vs. ≥10 mm. METHOD: This was a single-centre, retrospective cohort study including patients undergoing minimally invasive surgery for sigmoid colon cancer between May 2013 and May 2015. Follow-up CT scans were reviewed, and a vascular stump cut-off of <10 mm for adequate central ligation of the inferior mesenteric artery was applied. Differences in perioperative, histopathological and oncological outcome parameters (overall, disease-free and recurrence-free survival) were explored between <10 mm vs. ≥10 mm groups. RESULTS: A total of 127 patients (43% female) with a median age of 68 years were included. The median follow-up time was 68 months. CT measurements showed good interrater agreement (90% absolute agreement) and reliability among raters (kappa = 0.77, 95% CI 0.53-1.00, p < 0.001). A stump length ≥10 mm was associated with longer operating time (150 vs. 180 min, p = 0.021), intramesocolic resection (p = 0.008), and a shorter distance from the bowel wall to vascular tie (120 vs. 102 mm, p = 0.005). CONCLUSION: An arterial stump length ≥10 mm in sigmoid resection for colon cancer was associated with key clinical quality measures. Measurement of arterial stump length using routine follow-up CT may serve as a quality indicator of vascular ligation in CME surgery.


Assuntos
Neoplasias do Colo , Laparoscopia , Mesocolo , Neoplasias do Colo Sigmoide , Idoso , Colectomia , Neoplasias do Colo/diagnóstico por imagem , Neoplasias do Colo/cirurgia , Feminino , Humanos , Ligadura , Excisão de Linfonodo , Masculino , Mesocolo/diagnóstico por imagem , Mesocolo/cirurgia , Reprodutibilidade dos Testes , Estudos Retrospectivos , Neoplasias do Colo Sigmoide/diagnóstico por imagem , Neoplasias do Colo Sigmoide/cirurgia , Tomografia Computadorizada por Raios X , Resultado do Tratamento
5.
Gan To Kagaku Ryoho ; 48(4): 584-586, 2021 Apr.
Artigo em Japonês | MEDLINE | ID: mdl-33976056

RESUMO

A 66‒year‒old man was admitted to our hospital because of anemia and a positive fecal occult blood test in the medical examination. Colonoscopy revealed a type 2 advanced sigmoid colon cancer with circular stenosis. Computed tomography (CT)colonography was performed to examine the oral colon. The apple core signs were found both in the sigmoid and transverse colon. We diagnosed a double colon cancer and performed a laparoscopic left hemicolectomy and sigmoidectomy. The tumor was histopathologically diagnosed as a multiple cancer including a transverse and a sigmoid colon cancer. Although evaluations of the intestine for colon cancer with stenosis are performed by enema examination or endoscopic examination after colon stent placement, both examinations are invasive. CT colonography is considered to be a minimally invasive and an effective preoperative examination for colorectal cancer with stenosis.


Assuntos
Colo Transverso , Colonografia Tomográfica Computadorizada , Neoplasias Colorretais , Neoplasias do Colo Sigmoide , Idoso , Colo Sigmoide , Colonoscopia , Neoplasias Colorretais/diagnóstico por imagem , Humanos , Masculino , Neoplasias do Colo Sigmoide/diagnóstico por imagem , Neoplasias do Colo Sigmoide/cirurgia
6.
Gan To Kagaku Ryoho ; 48(4): 596-598, 2021 Apr.
Artigo em Japonês | MEDLINE | ID: mdl-33976060

RESUMO

The case is a 59‒year‒old woman. A detailed examination of fecal occult blood revealed a diagnosis of cStage Ⅳ sigmoid colon cancer cT3N1M1b(liver H2, hilar liver and celiac artery lymph nodes). After excision of the primary lesion, decided to give chemotherapy. The gene test was RAS gene mutation negative and EGFR positive, and mFOLFOX6 plus panitumumab (pani)was started as the first‒line treatment. Imaging tests at the end of 13 courses showed that the maximum diameter of liver metastases was reduced from 54 mm to 16 mm, and CEA was normalized from 93.9 ng/mL. However, metastasis was found in the hilar lymph nodes, it was judged that hepatectomy is not indicated, radiofrequency ablation therapy was performed. But FOLFIRI plus pani was restarted because metastatic liver tumor relapsed on CT 5 months later. After 6 courses, she felt tired, so I consulted her and changed to TAS‒102 plus bevacizumab. Sudden headache and vomiting appear during 3 courses, head CT revealed subarachnoid hemorrhage. No brain metastases or organic lesions such as cerebral aneurysms and stenotic lesions, the relationship with bevacizumab was strongly suspected.


Assuntos
Neoplasias Hepáticas , Neoplasias do Colo Sigmoide , Hemorragia Subaracnóidea , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Bevacizumab/uso terapêutico , Feminino , Fluoruracila/uso terapêutico , Humanos , Leucovorina/uso terapêutico , Neoplasias Hepáticas/tratamento farmacológico , Pessoa de Meia-Idade , Neoplasias do Colo Sigmoide/tratamento farmacológico , Neoplasias do Colo Sigmoide/cirurgia
7.
Int J Colorectal Dis ; 36(7): 1407-1419, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-33829313

RESUMO

PURPOSE: To compare single-incision laparoscopic surgery (SILS) and multiport laparoscopic surgery (MLS) for colorectal cancer in terms of short- and long-term outcomes. METHODS: A systematic literature search was performed in PubMed, Web of Science, and Embase. Randomized controlled trials (RCTs) and propensity-score matched (PSM) studies comparing SILS and MLS for colorectal cancer were enrolled. Outcomes of interests included intraoperative, postoperative, pathological, and survival outcomes. RESULTS: Sixteen studies (6 RCTs and 10 PSM studies) published between 2012 and 2020 with a total of 2425 patients were enrolled. Compared with MLS, SILS was associated with less postoperative pain at postoperative day (POD) 1 (P = 0.02, MWD = -0.73, 95%CI: -1.37, -0.09) and POD2 (P < 0.001, MWD= -1.10, 95%CI: -1.45, -0.74) and shorter length of total incision length (P < 0.001, MWD = -3.31, 95%CI: -3.95, -2.67). No differences were observed in terms of operative time, blood loss, intraoperative and postoperative complications, incision hernia, and pathological or survival outcomes between SILS and MLS. Subgroup analysis for right-sided colon cancer, sigmoid colon cancer, and rectosigmoid colon cancer showed that the SILS group was only associated with less postoperative pain and shorter total incision length. The surgical and pathological outcomes were comparable between SILS and MLS. CONCLUSIONS: SILS is a beneficial alternative to MLS in select colorectal cancer patients, especially for right-sided colon cancer, sigmoid colon cancer, and rectosigmoid cancer, with better cosmetic effects and less postoperative pain. Simultaneously, SILS does not compromise intraoperative and postoperative complications, surgical quality, or long-term outcomes.


Assuntos
Laparoscopia , Neoplasias do Colo Sigmoide , Colectomia , Humanos , Tempo de Internação , Duração da Cirurgia , Ensaios Clínicos Controlados Aleatórios como Assunto , Neoplasias do Colo Sigmoide/cirurgia , Resultado do Tratamento
9.
BMC Surg ; 21(1): 201, 2021 Apr 20.
Artigo em Inglês | MEDLINE | ID: mdl-33879122

RESUMO

BACKGROUND: Anastomosis-related complications are common after the radical resection of colon cancer. Among such complications, severe stenosis or completely occluded anastomosis (COA) are uncommon in clinical practice, and the separation of the anastomosis is even rarer. For such difficult problems as COA or anastomotic separation, clinicians tend to adopt surgical interventions, and few clinicians try to solve them through endoscopic operations. CASE PRESENTATION: In this article, we present a case of endoscopic treatment of anastomotic closure and separation after radical resection for sigmoid carcinoma. After imaging examination and endoscopic evaluation, we found that the patient had a COA accompanied by a 3-4 cm anastomotic separation. With the aid of fluoroscopy, we attempted to use the titanium clip marker as a guide to perform an endoscopic incision and successfully achieved recanalization. We used a self-expanding covered metal stent to bridge the intestinal canal to resolve the anastomotic separation. Finally, the patient underwent ileostomy takedown, and the postoperative recovery was smooth. The follow-up evaluation results showed that the anastomotic stoma was unobstructed. CONCLUSIONS: We reported the successful application of endoscopic technique in a rare case of COA and separation after colon cancer surgery, which is worth exploring and verifying through more clinical studies in the future.


Assuntos
Anastomose Cirúrgica/efeitos adversos , Colectomia/efeitos adversos , Colonoscopia/métodos , Constrição Patológica/cirurgia , Neoplasias do Colo Sigmoide/cirurgia , Deiscência da Ferida Operatória/cirurgia , Colo/diagnóstico por imagem , Colo/patologia , Colo/cirurgia , Constrição Patológica/diagnóstico por imagem , Constrição Patológica/etiologia , Fluoroscopia , Humanos , Ileostomia , Laparoscopia , Masculino , Pessoa de Meia-Idade , Implantação de Prótese , Stents Metálicos Autoexpansíveis , Neoplasias do Colo Sigmoide/tratamento farmacológico , Deiscência da Ferida Operatória/diagnóstico por imagem , Deiscência da Ferida Operatória/etiologia
11.
J UOEH ; 43(1): 103-115, 2021.
Artigo em Japonês | MEDLINE | ID: mdl-33678780

RESUMO

We report two cases of synchronous double primary cancers, which were composed of prostate cancer accompanied by bone metastasis and colon cancer, within only five months of each other. The first was a 77-year-old man whose ECOG PS was 0. He was referred to our hospital in March 2020 because abdominal CT scan, which was performed at a clinic for the purpose of close examination of poor control of diabetes, showed wall thickening of the sigmoid colon. A further examination revealed prostate cancer accompanied by metastatic bone cancer and sigmoid colon cancer. Laparoscopic sigmoid colectomy was performed in April. Currently, six months after the surgery, both the prostate cancer and its accompanying metastatic bone cancer are well controlled by hormonal therapy. The second case was an 86-year-old man with an ECOG PS of 3 who was brought to our hospital by ambulance in August, 2020 because of fever and abdominal pain. A close examination revealed cecal cancer accompanying acute appendicitis. Prostate cancer accompanied by metastatic bone cancer was also diagnosed. Laparoscopic ileocecal resection was performed in the same month, but, unfortunately, the patient had repeated aspiration pneumonia and he finally passed away 43 days after surgery. We discuss the treatment strategy for colorectal cancer with synchronous or metachronous prostate cancer, which has been increasing in recent years, and include epidemiological considerations.


Assuntos
Neoplasias do Apêndice/cirurgia , Neoplasias Ósseas/secundário , Neoplasias Primárias Múltiplas , Neoplasias da Próstata/patologia , Neoplasias do Colo Sigmoide/cirurgia , Idoso , Idoso de 80 Anos ou mais , Neoplasias do Apêndice/complicações , Apendicite/etiologia , Apendicite/cirurgia , Endoscopia Gastrointestinal , Evolução Fatal , Humanos , Laparoscopia , Masculino , Resultado do Tratamento
12.
BMC Surg ; 21(1): 82, 2021 Feb 12.
Artigo em Inglês | MEDLINE | ID: mdl-33579251

RESUMO

BACKGROUND: In recent years, natural orifice specimen extraction surgery (NOSES) has become a field of special interest for colorectal surgeons. Some researchers have reported transanal specimen extraction in the laparoscopic anterior rectal resection, including intersphincteric resection (ISR) and rectal eversion-resection. However, these surgical procedures have certain limitations. Based on the proven expertise in laparoscopic surgery, our center has developed a modified technique of transanal specimen extraction. The aim of this study was to investigate the safety and feasibility of a modified technique of transanal specimen extraction in the laparoscopic anterior rectal resection. METHODS: From January 2011 to January 2014, the patients with upper rectal or lower sigmoid colon cancer who had undergone laparoscopic anterior rectal resection with specimen extraction by a modified transanal technique were enrolled in the observation group, and the patients who had undergone laparoscopic anterior rectal resection with specimen extraction via an abdominal incision by the same surgeons during the same period were enrolled in the control group. RESULTS: A total of 36 patients were included in the observation group and 128 patients were included in the control group. There were no significant differences (P > 0.05) between the two groups in terms of the mean operative time [144 ± 10 min vs. 141 ± 11 min], mean intraoperative blood loss [63 ± 6 ml vs. 61 ± 7 ml], and the mean time to anal exhaust [67 ± 7 h vs. 65 ± 8 h]. However, there were significant differences (P < 0.05) between the two groups in terms of the mean postoperative Visual Analogue Scale (VAS) pain scores [3.4 ± 1.1 vs. 4.5 ± 1.2], mean postoperative hospital stay [6.0 ± 1.1 days ± vs. 7.2 ± 1.2 days], and incidence of postoperative complications (4/36 vs. 15/128). Long-term follow-up results showed that there was no significant difference (P > 0.05) between the two groups in terms of the 3- or 5-year overall survival. CONCLUSIONS: The modified technique of transanal specimen extraction in the laparoscopic anterior rectal resection fulfilled the principle of no-neoplasm touch technique, with advantages, such as minimal trauma, rapid recovery, and fewer complications. Long-term follow-up results also showed satisfactory oncological outcomes.


Assuntos
Laparoscopia/métodos , Neoplasias Retais/cirurgia , Reto/cirurgia , Neoplasias do Colo Sigmoide/cirurgia , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Retais/patologia , Reto/patologia , Estudos Retrospectivos , Neoplasias do Colo Sigmoide/patologia , Cirurgia Endoscópica Transanal
13.
Medicine (Baltimore) ; 100(3): e23914, 2021 Jan 22.
Artigo em Inglês | MEDLINE | ID: mdl-33545961

RESUMO

BACKGROUND: This study will assess the effect of sigmoidectomy in treating sigmoid colon cancer (SCC). METHODS: This study will search the following databases from inception to the present: MEDLINE, EMBASE, Cochrane Library, CINAHL, PsycINFO, Scopus, OpenGrey, Chinese Biomedical Literature Database, and China National Knowledge Infrastructure. All electronic databases will be searched with no restrictions of language. Two researchers will independently handle all study selection, data extraction, and risk of bias, respectively. Any disparities between 2 researchers will be figured out by a third researcher through discussion. RevMan 5.3 software will be used for statistical analysis in this study. RESULTS: This study will provide a high-quality synthesis of targeted outcomes to evaluate the efficacy and complications of sigmoidectomy in treating SCC. CONCLUSION: The results of this study will provide evidence to judge whether sigmoidectomy can benefit patients with SCC. STUDY REGISTRATION ON OSF: osf.io/dpxkg.


Assuntos
Colectomia , Neoplasias do Colo Sigmoide/cirurgia , Humanos , Revisões Sistemáticas como Assunto
14.
Gan To Kagaku Ryoho ; 48(2): 273-275, 2021 Feb.
Artigo em Japonês | MEDLINE | ID: mdl-33597379

RESUMO

A 80s year old man was referred to our hospital with melena. Colonoscopy revealed an elevated lesion in the sigmoid colon. Laparoscopic sigmoidectomy(D2)was performed in August 2011. Postoperative diagnosis was advanced sigmoid colon cancer(pT2N1M0 and pStage Ⅲa, UICC). In January 2015, He suffered from epigastric discomfort after meals. Gastrointestinal endoscopy revealed advanced gastric cancer and superficial esophageal cancer. For esophageal cancer, endoscopic submucosal dissection was performed with a diagnosis of cStage 0-Ⅱa(UICC). Laparoscopic distal gastrectomy with Billroth Ⅰ reconstruction was performed for gastric cancer with a diagnosis of pT1bN0M0 and pStage ⅠA(UICC). Follow up CT and MRI images in October 2016 showed a liver tumor in S4/S5. Laparoscopic partial liver resection was performed. Postoperative pathological diagnosis was hepatocellular carcinoma pT1N0M0, pStage Ⅰ(UICC). We finished following up period of the sigmoid colon cancer. Gastric cancer and esophageal cancer are followed up by gastrointestinal endoscopy once a year. Hepatocellular carcinoma is followed up every 3 months. He has no recurrence until now.


Assuntos
Carcinoma Hepatocelular , Neoplasias Esofágicas , Neoplasias Hepáticas , Neoplasias do Colo Sigmoide , Neoplasias Gástricas , Idoso de 80 Anos ou mais , Carcinoma Hepatocelular/cirurgia , Neoplasias Esofágicas/cirurgia , Humanos , Neoplasias Hepáticas/cirurgia , Masculino , Recidiva Local de Neoplasia , Neoplasias do Colo Sigmoide/cirurgia , Neoplasias Gástricas/cirurgia
16.
Clin J Gastroenterol ; 14(2): 613-616, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33421028

RESUMO

No cases of late recurrence of colorectal cancer liver metastasis (CRLM) over 10 years have been reported in the literature. A 72-year-old woman had a surgical history of sigmoid colectomy and partial hepatic resections for sigmoid colon cancer and multiple liver metastases 15 years previously. The patient had been postoperatively treated with chemotherapy for 6 months and was observed regularly with no recurrence. Computed tomography (CT) performed due to high carcinoembryonic antigen (CEA) revealed a tumor of 70 mm in diameter at the anterior segment of the liver and a 6-mm nodule at the left lateral segment. There was no other malignant finding. We performed central bisegmentectomy and partial resection of the liver. Pathological findings showed the tumors to be well to moderately differentiated adenocarcinoma, and positive cytokeratin 20 (CK20) and caudal-type homeobox transcription factor 2 (CDX2) expression with negative expression of cytokeratin 7 (CK7). In addition, the tumors showed cluster of differentiation 44 (CD44) and 133 (CD133) positive signified cancer stem cell immunohistochemically. The postoperative diagnosis was recurrence of hepatic metastasis of sigmoid colon cancer. We report a rare case of late recurrence of CRLM more than 15 years after the primary diagnosis.


Assuntos
Adenocarcinoma , Neoplasias Hepáticas , Neoplasias do Colo Sigmoide , Idoso , Feminino , Humanos , Neoplasias Hepáticas/diagnóstico por imagem , Recidiva Local de Neoplasia , Células-Tronco Neoplásicas , Neoplasias do Colo Sigmoide/cirurgia
17.
Asian J Endosc Surg ; 14(2): 267-270, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32790053

RESUMO

To perform complete mesocolic excision with central vessel ligation, it is important to recognize the vessel anomaly and the location of the tumor. For left-sided colon cancer, the variations in the course of the left colic artery and accessary middle colic artery must be recognized preoperatively. Here, we describe our experience with a 57-year-old man who was diagnosed with sigmoid colon cancer with complicated inter-mesenteric connections between the inferior mesenteric artery (IMA) and superior mesenteric artery (SMA), possibly due to median arcuate ligament syndrome. We performed laparoscopic sigmoidectomy with low ligation of the IMA to preserve the extremely enlarged left colic artery. The total operative time was 155 minutes, and the estimated total blood loss was 10 mL. The patient was discharged on postoperative day 9 without any postoperative complications. For patients with vascular anomalies in the left-sided mesocolon, preoperatively ruling out SMA stenosis by using angiography and 3-D CT might be important.


Assuntos
Laparoscopia , Neoplasias do Colo Sigmoide , Colo Sigmoide , Comunicação , Humanos , Excisão de Linfonodo , Masculino , Artéria Mesentérica Inferior/diagnóstico por imagem , Artéria Mesentérica Inferior/cirurgia , Pessoa de Meia-Idade , Neoplasias do Colo Sigmoide/complicações , Neoplasias do Colo Sigmoide/diagnóstico por imagem , Neoplasias do Colo Sigmoide/cirurgia
18.
Asian J Endosc Surg ; 14(1): 94-96, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32567167

RESUMO

Informed by our experiences with reduced-port surgery for colorectal cancer, we performed the first single-incision plus two-port robotic sigmoidectomy for cancer with the Senhance robotic system. A 70-year-old woman presented to our department for the treatment of sigmoid colon cancer. We performed single-incision two-port robotic sigmoidectomy. A wound protector was inserted through a 3.0-cm transumbilical incision, a multiport access device was mounted on top of it, and then a camera port and a 5-mm assistant's port were placed in the multiport access device. Two extra ports were placed on the central line of the abdomen. Lymph node dissection around the inferior mesenteric artery and mobilization of the left-sided colon were completed without any perioperative complications. The total operative time was 204 minutes, and the console time was 113 minutes. The estimated blood loss was 75 mL. The patient was discharged on postoperative day 8 without any complications.


Assuntos
Colectomia , Laparoscopia , Procedimentos Cirúrgicos Robóticos , Neoplasias do Colo Sigmoide , Idoso , Colectomia/instrumentação , Colectomia/métodos , Feminino , Humanos , Laparoscopia/instrumentação , Laparoscopia/métodos , Excisão de Linfonodo , Duração da Cirurgia , Procedimentos Cirúrgicos Robóticos/instrumentação , Procedimentos Cirúrgicos Robóticos/métodos , Neoplasias do Colo Sigmoide/cirurgia
19.
J Laparoendosc Adv Surg Tech A ; 31(11): 1227-1231, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33164666

RESUMO

Background: With the development of surgical technology, surgeons are paying more and more attention to minimally invasive procedures such as injury reduction, pain reduction, and beautiful incisions to ensure the effectiveness of surgical treatment. This article discusses the safety, feasibility, and clinical outcomes of laparoscopic resection of sigmoid colon and rectal tumors via natural orifice specimen extraction surgery (NOSES). Materials and Methods: The clinical data of 39 patients who underwent complete laparoscopic resection of sigmoid colon tumor or rectal tumor at Chengde Medical College Hospital between 2018 and 2020, including general patient data (gender, age, body mass index [BMI], etc.), surgery-related data, general postoperative conditions, and postoperative pathological data, were retrospectively analyzed to explore the feasibility and safety of NOSES. Results: The specimens were all removed through the anorectal resection drag out type. The average age of 39 patients was 61.3 ± 10.2 years, the average BMI was 24.0 ± 3.1 kg/m2, the average postoperative hospital stay was 11.2 ± 4.4 days, 12 patients with sigmoid colon tumors, including 11 malignant tumors and 1 schwannoma, 27 rectal tumors, including 1 rectal villous tubular adenoma, among the 37 patients with malignant tumors, ulcer type 32 cases of adenocarcinoma and 5 cases of mass adenocarcinoma, mean number of lymph nodes detected intraoperatively (11.9 ± 3.9), mean operative time (162.9 ± 43.0 minutes), mean operative bleeding (36.9 ± 13.0 mL), mean time of initial exhaust (4.3 ± 3.0) days, mean time of laparoscopic drainage tube removal (9.8 ± 1.4) days, mean time of postoperative feeding (4.4 ± 3.0) days, the average maximum tumor diameter (3.7 ± 1.4 cm), and the average distance of the tumor from the anal margin (14.1 ± 6.1 cm); after surgery, there were two cases of anastomotic fistula. Conclusion: Laparoscopic resection of sigmoid colon and rectal tumors via natural orifice specimen extraction has the advantages of less pain, reduced incisional complications, good safety, and accurate efficacy in clinical applications.


Assuntos
Laparoscopia , Cirurgia Endoscópica por Orifício Natural , Neoplasias Retais , Neoplasias do Colo Sigmoide , Adulto , Colo Sigmoide , Humanos , Neoplasias Retais/cirurgia , Estudos Retrospectivos , Neoplasias do Colo Sigmoide/cirurgia , Resultado do Tratamento
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