China
Africa
Explore chapters and articles related to this topic
General Surgery
Published in Tjun Tang, Elizabeth O'Riordan, Stewart Walsh, Cracking the Intercollegiate General Surgery FRCS Viva, 2020
Rebecca Fish, Aisling Hogan, Aoife Lowery, Frank McDermott, Chelliah R Selvasekar, Choon Sheong Seow, Vishal G Shelat, Paul Sutton, Yew-Wei Tan, Thomas Tsang
You undertake a right hemicolectomy. How do you fashion your anastomosis?Say what YOU do, and why. There are two options: stapled or handsewn.Appositional hand-sewn serosubmucosal anastomosis Mesenteric defects not closedBest results in literature (leak rates of 0.5%–3%)Stapled anastomosis ‘Functional end to end’ for right hemicolectomyCheck the staple line for bleedingClose defect with linear staplerNo consistent difference in leak rates between two techniques
Gastrointestinal cancer
Published in Peter Hoskin, Peter Ostler, Clinical Oncology, 2020
Tumours of the colon are treated by hemicolectomy with either immediate reanastomosis (usual) or formation of a temporary colostomy, which can be closed at a later date. En bloc removal of regional lymph nodes should be included with a minimum of 12 nodes to achieve accurate staging information. Some surgeons ligate the vascular pedicle prior to mobilization of the tumour to try to prevent vascular dissemination of tumour. Laparoscopic-assisted colectomy is associated with more rapid recovery and reduced hospital stays.
Surgical Management of Colon Cancer
Published in Peter Sagar, Andrew G. Hill, Charles H. Knowles, Stefan Post, Willem A. Bemelman, Patricia L. Roberts, Susan Galandiuk, John R.T. Monson, Michael R.B. Keighley, Norman S. Williams, Keighley & Williams’ Surgery of the Anus, Rectum and Colon, 2019
The general, pragmatic rule for the extent of vascular dissection is that the central vessels supplying the part of the bowel affected by the tumour should be taken down on both sides (e.g. caecal tumour: right colic vessels and ileocolic vessels; ascending colon: ileocolic vessels, right colic vessels, middle colic vessels; see Figures 31.1 and 31.2). This concept results in doing extended right or left hemicolectomies in patients with cancers of the right or left transverse colon. As an exception, in patients with a central transverse colon, a pure transverse colonic resection can be done, only comprising one central vessel (middle colic vessels), as the distance to the other vascular and lymphatic drainages is seemingly far enough. In patients with cancer of the descending colon, again a left hemicolectomy is done (middle colic vessels and left colic vessels taken down). In sigmoid cancers, either a left hemicolectomy (see above), a mere sigmoid resection (only in cases where the tumour is in the middle of the sigmoid; inferior mesenteric and left colic both can then be preserved in selected cases) or a high anterior rectosigmoid resection if the tumour is in the distal sigmoid, are performed.
Triumph against cancer: invading colorectal cancer with nanotechnology
Published in Expert Opinion on Drug Delivery, 2021
Preksha Vinchhi, Mayur M. Patel
Surgical approach for the treatment of colon cancer includes Colectomy i.e. surgical removal of the part of the colon or full colon (depending on the tumor spread) and en bloc resection of surrounding lymph nodes. Colectomy can be termed as hemicolectomy, segmental resection or partial colectomy in the case of the removal of only some part of the colon, while removal of the whole colon is called total colectomy. Either open surgery or laparoscopic resection can be done to perform colectomy. Even though laparoscopic surgery is found to be as safe as open surgery, there are some limitations associated with laparoscopic surgery like problems associated due to previous abdominal surgeries, advanced disease stage, obesity, etc [22,39]. Loop colostomy or permanent colostomy is often required in which a stoma is formed for diverting feces in a bag placed outside the body. Avoiding the need for permanent colostomy is an essential target to be achieved by surgeons. However, employing highly precise surgical techniques and recent stapling devices, the permanent colostomy can be generally avoided except when the anal sphincter is also involved in very low rectal tumors. The surgical procedure widely used in the treatment of rectal cancer is total mesorectal excision (TME) that includes removal of rectum, mesorectum, and mesorectal fascia. Surgical procedures like laparoscopy-assisted TME, transanal excision, low anterior resection, abdominoperineal resection, coloanal anastomosis, proctectomy, etc. are also employed depending on the location of the tumor [40].
A Nomogram for Predicting Lymph Nodal Metastases in Patients with Appendiceal Cancers: An Analysis of SEER Database
Published in Journal of Investigative Surgery, 2021
Dan Wang, Chongshun Liu, Tingyu Yan, Chenglong Li, Cenap Güngör, Qionghui Yang, Yang Xu, Lilan Zhao, Qian Pei, Fengbo Tan, Yuqiang Li
It is a great challenge for surgeons to determine whether right hemicolectomy is appropriate to be performed for those patients, who was diagnosed as appendiceal cancer during surgery, with unknown status of lymph node (LN) metastasis [11]. Currently, the treatment of appendiceal adenocarcinoma mainly referred to the treatment guidelines for colon cancer, but there was no specific treatment guidelines [12]. Besides, some research recommended that performance of local right hemicolectomy should be based on tumor size and histology [13,14]. The treatment guidelines, published by National Comprehensive Cancer Network (NCCN), recommended that patients with ≤ 2 cm appendiceal carcinoid tumors can be treated by appendectomy alone. However, right hemicolectomy was recommended for appendiceal neuroendocrine tumor larger than 2 cm since the risk of LN metastasis increased with growing tumor [14]. The European society of neuroendocrine tumor (ENETS) appendix neuroendocrine occult cancer guidelines suggested right-side colon resection for patients with any of the following: 1 to 2 cm but edge positive or undefined, or deep in the appendix, the high level or vascular invasion, and all appendices neuroendocrine tumor patients > 2 cm13. Although previous studies assessed the potential risk of LN metastasis, there was a lack of large-scale national database studies which could quantify the overall risk of LN metastasis in appendiceal cancer patients [15–17].
HER2 overexpression is a putative diagnostic and prognostic biomarker for late-stage colorectal cancer in North African patients
Published in Libyan Journal of Medicine, 2021
Eman A. Abdul Razzaq, Thenmozhi Venkatachalam, Khuloud Bajbouj, Mohamed Rahmani, Amena Mahdami, Surendra Rawat, Naziha Mansuri, Hussein Alhashemi, Rifat Akram Hamoudi, Riyad Bendardaf
It has been clearly demonstrated that HER2 gene amplification differs significantly between right/left-sided and rectal carcinomas. In our study, most of the cases that scored 2+ and 3+ CRC ended up having right hemicolectomy. A right hemicolectomy is usually performed for cancer of the cecum and ascending colon, and for some hepatic flexure. A left hemicolectomy is appropriate for tumors in the distal transverse or descending colon and for selected patients with proximal sigmoid colon cancer. While mortality and major complications are comparable to both sides, in right-sided colectomies, patients were less likely to have a superficial infection due to the surgery. Regarding the malignancy status, patients with right-sided colon cancers are different than those with left-sided cancers. They are older, present at a more advanced stage, and have a higher unadjusted mortality rate postoperatively [21]. In our study, the patients are rather older in age and with more advanced cancer, matching the previous reports. Moreover, previous studies in Libya have revealed that women are more likely to be affected by a right colon tumour [3]. Furthermore, another study found that distal CRC was more prevalent in Libya [4].