دورية أكاديمية
Long splenic flexure carcinoma requiring laparoscopic extended left hemicolectomy with CME and transverse-rectal anastomosis. technique for a modified partial Deloyers in 5 steps to achieve enough reach and preserving middle colic vessels
| العنوان: | Long splenic flexure carcinoma requiring laparoscopic extended left hemicolectomy with CME and transverse-rectal anastomosis. technique for a modified partial Deloyers in 5 steps to achieve enough reach and preserving middle colic vessels |
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| المؤلفون: | Di Saverio S., Stasinos K., Stupalkowska W., Bracale U., Sileri P., Giuliani A., Nigri G., Kouroumpas E., Wheeler J. M. D., Tebala G. D., Di Marzo F., De Simone B., Idoate C. P., De Angelis N., Cirocchi R., Tejedor P. |
| المساهمون: | Di Saverio, S., Stasinos, K., Stupalkowska, W., Bracale, U., Sileri, P., Giuliani, A., Nigri, G., Kouroumpas, E., Wheeler, J. M. D., Tebala, G. D., Di Marzo, F., De Simone, B., Idoate, C. P., De Angelis, N., Cirocchi, R., Tejedor, P. |
| بيانات النشر: | Springer Science and Business Media Deutschland GmbH ONE NEW YORK PLAZA, SUITE 4600, NEW YORK, NY, UNITED STATES |
| سنة النشر: | 2022 |
| المجموعة: | Sapienza Università di Roma: CINECA IRIS |
| مصطلحات موضوعية: | colonic derotation, complete mesocolic excision, deloyers procedure, embryology, left extended colectomy, splenic flexure carcinoma, aged, anastomosis, surgical, colectomy, female, human, adenocarcinoma, colic, colon, transverse, colonic neoplasm, laparoscopy |
| الوصف: | Introduction: This How-I-Do-It article presents a modified Deloyers procedure by mean of the case of a 67-year-old female with adenocarcinoma extending for a long segment and involving the splenic flexure and proximal descending colon who underwent a laparoscopic left extended hemicolectomy (LELC) with derotation of the right colon and primary colorectal anastomosis. Background: While laparoscopic extended right colectomy is a well-established procedure, LELC is rarely used (mainly for distal transverse or proximal descending colon carcinomas extending to the area of the splenic flexure). LELC presents several technical challenges which are demonstrated in this How-I-Do-It article. Technique and methods: Firstly, the steps needed to mobilize the left colon and procure a safe approach to the splenic flexure are described, especially when a tumor is closely related to it. This is achieved by mobilization and resection of the descending colon, while maintaining a complete mesocolic excision to the level of the duodenojejunal ligament for the inferior mesenteric vein and flush to the aorta for the inferior mesenteric artery. Subsequently, we depict the adjuvant steps required to enable a primary anastomosis by trying to mobilize the transverse colon and release as much of the mesocolic attachments at the splenic flexure area. Finally, we present the rare instance when a laparoscopic derotation of the ascending colon is required to provide a tension-free anastomosis. The resection is completed by delivery of the fully derotated ascending colon and hepatic flexure through a suprapubic mini-Pfannenstiel incision. The primary colorectal anastomosis is subsequently fashioned in a tension-free way and provides for a quick postoperative recovery of the patient. Results: This modified Deloyers procedure preserves the middle colic since the fully mobilized mesocolon allows for a tension-free anastomosis while maintaining better blood supply to the mobilized stump. Also, by eliminating the need for a mesenteric window and the ... |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| العلاقة: | info:eu-repo/semantics/altIdentifier/pmid/34269879; info:eu-repo/semantics/altIdentifier/wos/WOS:000673255600001; volume:407; issue:1; firstpage:421; lastpage:428; numberofpages:8; journal:LANGENBECK'S ARCHIVES OF SURGERY; http://hdl.handle.net/11573/1640855Test; info:eu-repo/semantics/altIdentifier/scopus/2-s2.0-85111832510 |
| DOI: | 10.1007/s00423-021-02240-7 |
| الإتاحة: | https://doi.org/10.1007/s00423-021-02240-7Test http://hdl.handle.net/11573/1640855Test |
| حقوق: | info:eu-repo/semantics/openAccess |
| رقم الانضمام: | edsbas.E25BD78F |
| قاعدة البيانات: | BASE |
| DOI: | 10.1007/s00423-021-02240-7 |
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