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Colorectal Surgery for Deep Endometriosis Infiltrating the Bowel
Published in Nazar N. Amso, Saikat Banerjee, Endometriosis, 2022
Hanan Alsalem, Jean-Jacques Tuech, Damien Forestier, Benjamin Merlot, Myriam Noailles, Horace Roman
Segmental resection is one of the main procedures used to manage bowel diseases in colorectal surgery. In advanced cases of bowel rectovaginal endometriosis, when the infiltration is of a large size and is responsible for stenosis of the bowel, segmental resection is then unavoidable. In the United States, the reported rate of colorectal resection indicated for endometriosis increased from 0.19% to 0.29% between 2006 and 2014.
Endometriosis
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
André D’Hoore, Andrew R.L. Stevenson
This is rather uncommon and is usually due to a lesion that occludes the small bowel (terminal ileum) (see Figures 82.5 and 82.6). A segmental resection should be performed. There is no role for a strictureplasty as in Crohn’s disease.
Malignant Neoplasms of the Colon
Published in Philip H. Gordon, Santhat Nivatvongs, Lee E. Smith, Scott Thorn Barrows, Carla Gunn, Gregory Blew, David Ehlert, Craig Kiefer, Kim Martens, Neoplasms of the Colon, Rectum, and Anus, 2007
Dogma abounds with respect to the technical aspects of operation for colorectal carcinoma. The general principles advocated for all operations for carcinoma include removal of the primary lesion with adequate margin, including the areas of lymphatic drainage. The definition of an adequate margin especially for rectal carcinoma remains controversial. Approximately one half of the patients seeking operative treatment already have metastatic disease spread to the regional lymph nodes. Controversy exists as to the appropriate extent of lymphatic dissection. Is a segmental resection adequate therapy? Or with a sigmoid carcinoma, for example, should a formal left hemicolectomy be performed? For the most part the literature suggests that no survival advantage can be attributed to extended lymph node dissections for left colon and rectal carcinoma (386–389). An exception is the isolated report by Enker, Laffer, and Black (390). Without doubt this operation does result in increased morbidity, with patients often suffering from impotence, bladder difficulties, and potential vascular problems. Any marginal improvement is outweighed by the considerable morbidity. The principle of en bloc resection of involved structures is firmly established. Continued controversy surrounds radical lymph node dissection, luminal ligation, oophorectomy, and the “no-touch technique.” What is becoming increasingly evident is that differences in outcome among different surgeons suggest that technique is important. Whether a properly performed lymphadenectomy may produce a therapeutic benefit or whether it is simply a more accurate staging procedure is unknown.
A Novel Experimental Model of Colorectal Endometriosis
Published in Journal of Investigative Surgery, 2018
Anastasia Prodromidou, Vasilios Pergialiotis, Kitty Pavlakis, Laskarina Maria Korou, Maximos Frountzas, Dimitrios Dimitroulis, Georgios Vaos, Despina N. Perrea
The management of DIE is mainly surgical but still remains challenging. Despite the variety of surgical interventions that have been used, none of them seems to be more effective. To date, the two prevailing surgical approaches comprise either the resection of the part of the affected colon or the excision of the endometriotic nodule by shaving or disc excision [9]. Some studies indicate that colorectal segmental resection might be more effective for the treatment of DIE and that this treatment strategy does not result in major complications [8, 10]. On the other hand, several recent studies suggest other less invasive techniques as a way to limit adverse post-surgical outcomes, which can follow a segmental resection of the colon such as anastomotic leak and rectovaginal fistula [11, 12]. The comparison of segmental resections and minimally invasive surgical techniques has been investigated in a series of studies [13–15]. The authors concluded that shaving and discoid resection should be chosen as alternative procedures to improve postoperative morbidity instead of segmental resection in selected patients, depending on characteristics of the lesion and the surgeon's experience [13–15]. On that note, lesions no more than 3 cm in size which surround less than one-half to one third of the rectum are deemed as resectable [16].
Odontogenic myxoma involving the right nasal cavity, orbital floor, and skull base in a 20-year-old woman: Removal and review of the literature
Published in Acta Oto-Laryngologica Case Reports, 2023
Danlin Huang, Fei Liu, Junyi Liang, Xiao Xing, Xingsha Wu, Shuai Yang, Xinfeng Wei, Shuo Li
We surgically resected the lesion by performing a transnasal endoscopic anterior lacrimal fossa combined with Collus’s approach to the right nasal sinus tumor. According to the nasal endoscopic image, the tumor was totally removed and the surrounding normal tissue mucosa was extensively scraped to preserve part of the middle turbinates, skull base, orbital floor wall, and bone wall in the maxillary sinus. Due to the large cumulative range of Odontogenic myxoma tumors in this patient, we opted for conservative treatment . Because the segmental resection and reconstruction are more traumatic to the organism, and the patient is now only 20 years old, a female patient, we used a minimally invasive surgical approach as much as possible while ensuring a reduced risk of recurrence.
Duodenal adenocarcinoma: neoadjuvant and adjuvant therapy strategies
Published in Expert Opinion on Orphan Drugs, 2019
Apeksha Dave, Jason T. Wiseman, Jordan M. Cloyd
Second, management should be based largely on the resectability of the tumor. Those patients with localized DA should undergo surgical resection with a goal of R0 margins and adequate regional lymphadenectomy. The choice of surgical approach (PD versus segmental resection) is based on the location of the tumor and the ability to achieve negative margins while preserving the ampulla of Vater.