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At least 1,225 records · Page 68Linked to original sources
PubMed2002

Hand-assisted laparoscopic colon mobilization for esophageal reconstruction.

BACKGROUND: New techniques for hand-assisted laparoscopic colon surgery have been adopted quickly for the treatment of numerous colorectal diseases. However, reports of laparoscopic colonic mobilization for esophageal reconstruction are rare. In this report we describe an improved procedure for esophageal reconstruction with transverse colon. METHODS: From January 1999 to April 2001, we recruited seven patients (5 women and 2 men) who acquired esophageal stricture after swallowing hydrogen chloride or lye. The mean age of the patients was 42.7 years. For surgery, the patients were placed in lithotomy position under single-lumen intubated anesthesia. First, hand-assisted laparoscopic colon mobilization was performed with the assistance of the Harmonic Scalpel (AutoSuture Company, Norwalk, CT, USA) through a 7-cm upper abdominal incision. Then using cervical esophagocolostomy through the retrosternal route, coloenterostomy and colocolostomy were achieved. RESULTS: The mean operative time was 3.9 h (range, 3.2-5 h). The mean hospital stay was 9.1 days (range, 8-13 days). Mean blood loss was 100 ml (range, 50-350 ml). All the patients obtained successful outcomes. There was one mild abdominal wound infection, and no surgical mortality. At this writing, the seven patients can eat solid food very well after a mean follow-up period of 18.2 months. CONCLUSIONS: Hand-assisted laparoscopic colonic mobilization for esophageal reconstruction is a safe and feasible operation for treating patients with esophageal stricture.

Adult↗
PubMed1983

Management of diverticulitis of the ascending colon. 10 years' experience.

Diverticulitis of the ascending colon is an uncommon disease which mimics appendicitis. The correct diagnosis is rarely made, but can be suggested by the patterns of signs and symptoms and confirmed by barium contrast study. Diverticulitis of the ascending colon should be treated by the same plan as diverticulitis of the left colon. If the diagnosis is established, nonoperative management is indicated initially. Operation is indicated when the diagnosis is in doubt, when perforation has occurred, or when the patient does not respond to nonoperative treatment. At operation, ascending colon diverticulitis can be recognized as an inflammatory mass involving the wall and mesentery of the colon. The inflammatory mass is best treated by resection with primary anastomosis of the ileum to the ascending or transverse colon in an area removed from the site of infection.

Adult↗
PubMed1999

Colonic stenosis after hemolytic-uremic syndrome.

Colonic necrosis and intestinal perforation are the usual surgical complications of hemolytic syndrome. We present a case of right transverse colon stricture following hemolytic-uremic syndrome.

Colonic Diseases↗
PubMed2005

Identification of the location of the colonic pacemakers: a histologic study.

A recent electrophysiologic study has suggested the existence of 4 pacemakers in the colon which generate the electric waves that are responsible for the colonic motor activity. These pacemakers are located at the cecal pole, the cecocolonic junction, the mid third of the transverse colon and at the colosigmoid junction. We investigated the hypothesis that these pacemaker sites contain ICCs in great numbers and that the electric waves generated from these sites are transmitted by a chain of ICCs to the remaining colon. Specimens were taken from the 4 electrophysiologically defined pacemaker sites and the remaining colon of 24 cadavers. They were subjected to c-kit immunohistochemistry tests. Controls for antisera specificity consisted of tissue incubation with normal rabbit serum substituted for the primary antiserum. The morphometric study was performed by submitting the immunohistochemically-stained sections to image analysis in order to determine the area percent of immuno-reactivity in comparison to the total area of fields examined in the sections. Data obtained from the image analyzer were statistically analyzed. Immunohistochemical and morphometric studies have shown that the 4 electrophysiologically defined pacemaker sites contained a significantly higher proportion of ICCs than the remaining colon, the ICCs at these sites being multipolar and forming a network surrounded by a fibrous tissue wall. In the remaining colon, the ICCs were bipolar and arranged in a linear fashion. The study revealed the existence of a network of ICCs at the 4 pacemaker sites forming the 'pacemaker nodes' (PMNs). In the rest of the colon, a chain of ICCs extended in the colonic wall in a linear fashion forming the 'pacemaker bundles' (PMBs). We postulate that the colonic electric waves start at the PMNs and spread in the colon along the PMBs.

Animals↗
PubMedDate not supplied

[The surgical treatment of obstructive cancers of the left colon. Apropos of a series of 66 cases].

From 1977 to 1989, 66 patients were operated on in emergency, without any bowel preparation, for acutely obstructing left-sided colon cancer. Two synchronous cancers were diagnosed and the 68 tumours were located as follows: 13 on the left transverse colon or at the splenic flexure, 7 on the descending colon, 37 on the sigmoid, and 11 at the rectosigmoid junction or below. According to Astler-Coller staging, 15 patients were classified as B, 17 as C and 25 as D. Initial treatment was a colostomy in 58 patients (88%), or a resection with or without anastomosis in 2 and 6 cases respectively. Most patients underwent a two- or more rarely a three-stage resection and 44 patients left the hospital without either tumour or stomy. Cumulative operative mortality was 12%. Five-year survival rates were 21% for the patients with a minimal potential follow-up of 5 years, and 39% for curative resections (disease-free survival of 33%). From these results, we think that two-staged resection, with close proximal colostomy followed by resection and anastomosis, remains an appropriate approach for most obstructing left-sided colon cancers; more tempting procedures such as resection with primary anastomosis or subtotal colectomy are probably indicated in selected patients.

Adult↗
PubMed1984

[Anterothoracic colonic replacement in cicatricial caustic strictures of the esophagus in a 1-stage procedure].

Five cases of oesophageal stricture secondary to caustic ingestion are presented. The colon, as a total bypass graft, was applied in all patients; two with right hemicolon and three with isoperistaltic transverse colon. The colon was placed subcutaneously, with the operation being performed as a one-stage procedure. A good functional result of the colon bypass, could be achieved in all persons.

Accidents, Home↗
PubMed1981

[Pathogenesis of colon diverticular disease (author's transl)].

The longitudinal musculature of the taenia of the colon does play an important role in diverticular disease (DD), as can be found by comparing light and electron microscopic pictures of the colon from healthy persons and patients with diverticulitis and ulcerative colitis. Already in the early stages histological changes can be found, which have to be interpreted as being due to maximal contraction of the longitudinal musculature and to increased metabolism. These morphological changes are accompanied by increased electrical and mechanical activity. Disturbed function seems to be myogenic, as could be shown by studies with different drugs. These results seem to indicate that it might be preferable to incise the longitudinal musculature of the colon transversally during surgery because of diverticulosis.

Colitis, Ulcerative↗
PubMed1994

A small pedunculated adenomatous polyp of the colon found to contain the focus of invasive carcinoma extending to the serosa: report of a case.

A small pedunculated polyp was detected among other polyps in the transverse colon of a 64-year-old man, the resected specimen of which showed an adenomatous polyp 1 cm in diameter, containing the foci of adenocarcinoma invading the submucosa, muscularis, and serosa. This case report stresses the importance of performing careful pathologic examination of resected specimens obtained from endoscopic polypectomy, even for small pedunculated colon polyps.

Adenocarcinoma↗
PubMedDate not supplied

Herniation of colon following transhiatal esophagectomy.

We report a 38-year-old man with intestinal obstruction following transhiatal esophagectomy for carcinoma esophagus; it occurred secondary to herniation of the transverse colon through the esophageal hiatus into the mediastinum. The patient is asymptomatic after reduction of the hernia and repair of the disphragmatic hernia.

Adult↗
PubMed2000

Colon interposition.

In the anatomy of the colon vasculature, the ascending branch of the left colic artery is the primary supplying vessel (96.91%). Isoperistaltic transposition of the transverse colon is preferred (83.58%). Riolan's vascular arcade is not a major vessel of the colon. It can only be found in less than 10% of patients, and whether or not this arcade is complete cannot be used as criterion to judge colon blood supply. Animal experiments and clinical studies have confirmed the superiority of one-layer over two-layer anastomosis. The former is simpler, safer, and more reliable, with a lower incidence of anastomotic leak or stricture. Based on a comprehensive evaluation of the disease type, patient age, heart and lung functions, nutritional status, and accompanying diseases, three colon transposition routes are available (anterosternal subcutaneous tunnel, retrosternal tunnel, and esophageal bed passage). The advantages and disadvantages of each route are analyzed, and the left-middle-left retrosternal route is described. The indications for esophageal reconstruction with colon operation (ERC) were collected and verified, increasing the number of indications to seven categories of diseases. The main complications of ERC, i.e., colon segment necrosis, anastomotic leak, recurrent laryngeal nerve injury, and intestinal obstruction were systematically studied, and their causes and prevention are detailed. The number of patients is the highest in a single unit among all the published reports. The incidence of complications and deaths are the lowest.

Adolescent↗
PubMed2004

Minilaparotomy approach for removal of a large colonic lipoma: report of two cases.

A minimally invasive surgical approach should be employed to resect symptomatic colonic lipomas whenever possible. We report two cases of large colonic lipomas that were successfully removed using a minimally invasive minilaparotomy approach. Patient 1 was a 53-year-old man with a 3.8-cm symptomatic submucosal lipoma in the ascending colon and patient 2 was a 57-year-old woman with a 4.2-cm symptomatic submucosal lipoma in the transverse colon. Both lipomas were successfully removed through a 5-7-cm minilaparotomy. Normal bowel function returned quickly without any postoperative complications. These case reports demonstrate that the minilaparotomy approach is a suitable alternative to conventional laparotomy to remove a large colonic lipoma.

Colonic Neoplasms↗
PubMed1982

A possible central serotonergic mechanism involved in the effects of morphine on colonic motility in dog.

The effects of morphine (0.1 mg/kg) and 5-HTP (2 mg/kg) on colonic motility were investigated in dogs fasted for 15-22 h and fitted with two strain gauge transducers on the transverse colon at 8 and 12 cm from the ileo-colonic junction. The effects were compared to those obtained after previous intravenous (i.v.) (0.2 mg/kg) or intracerebroventricular (i.c.v.) (10 micrograms/kg) administration of methysergide. Morphine (0.1 mg/kg) increased the colonic motility index by 475% from 0 to 30 min, this primary transient stimulatory response being followed 30-40 min later by a secondary response lasting 3.2 +/- 0.5 h during which the motility index was also significantly increased. Intravenous injection of 5-HTP (1 mg/kg) produced a delayed (30-40 min) colonic hyperactivity with a 160% increase in the motility index from 1 to 3 h after injection similarly to the secondary response to morphine. This secondary colonic hyperactivity induced by morphine was blocked by both i.v. and i.c.v. methysergide administration--whereas the hyperactivity induced by 5-HTP was not blocked by previous i.v. or i.c.v. administration of methysergide--indicating that the similar effects of morphine and 5-HTP on colonic motility are not caused by the same mechanism. It was concluded that the long-lasting stimulatory effects of morphine on colonic motility in dog are centrally mediated and blocked at this level by 5-HT antagonists.

5-Hydroxytryptophan↗
PubMed1999

Improvement of survival over time for colon cancer patients by anatomical sub-sites.

The aims of this study are to describe and to evaluate improvement of survival over time for colon cancer patients by anatomical sub-sites. Data on 661 patients newly diagnosed as having colon cancer at Osaka Medical Center for Cancer and Cardiovascular Diseases from 1978 to 1991 were examined in this study. Corrected survival was calculated with the Kaplan-Meier method according to the period of diagnosis: early period (1978-84) and later period (1985-91). Factors concerning the difference in survival between the two periods were examined with the Cox proportional hazards regression model according to sub-site. Five-year corrected survival of the patients with left colon cancer improved significantly (60 to 72%; P < 0.01), probably due to advances in treatment, while that of patients with transverse colon cancer also improved significantly (39 to 67%; P < 0.01), mainly because of progress in diagnosis. The five-year corrected survival of those with right colon cancer did not increase (57 to 46%; P = 0.14), owing to lack of improvement in stage at diagnosis. Among the three sub-sites, the right showed the worst five-year survival in the later period. We concluded that survival of patients with right colon cancer, differing from the other anatomical sub-sites, did not improve, possibly because of lack of symptoms. The screening programs for colon cancer introduced in Japan in 1992 may be expected to improve the survival of patients with colon cancer, including that of the right colon.

Age Factors↗
PubMedDate not supplied

Intussusception up to splenic flexure by cecal carcinoma in an adult: report of a case.

A 73-year-old woman was admitted because of constipation and appetite loss. She was diagnosed as having intussusception caused by a colonic tumor, based on the results of physical examination and imaging such as ultrasonography, computed tomography and barium enema. Operation revealed that right colon from the cecum up to the hepatic flexure of the ascending colon was not fixed to the retroperitoneum, and a circular cecal carcinoma was invaginated to the splenic flexure of the transverse colon. We experienced a rare case of ileocolic intussusception up to the splenic flexure by a cecal carcinoma with mesenterium ileo-colicum commune in an adult.

Aged↗
PubMed2003

[Osseous metaplasia in a colonic adenocarcinoma].

Osseous metaplasia is rare in tumors of the gastrointestinal tract. We report the case of a 76-year-old man presenting with an adenocarcinoma of the transverse colon containing osseous tissue. Calcifications were seen on the abdominal CT-scan. Pathogenesis of the osseous metaplasia is still unknown.

Adenocarcinoma↗
PubMed1990

Ruptured mature cystic teratoma of the ovary with recurrence in the liver and colon 17 years later. A case report.

A mature cystic teratoma of the ovary occurred in a 51-year-old woman and recurred as a large intrahepatic tumor mass as well as a small mass in the transverse colon 17 years after rupture, intraperitoneal spillage of tumor contents and subtotal surgical removal of the ovarian lesion and peritoneal implants. The patient was treated with a partial hepatectomy and a segmental transverse colectomy. The recurrent lesions, which contained histologically fully mature teratomatous elements only, were excised; the result was a complete cure. To our knowledge this is the first documented report on such a complication of mature cystic teratoma of the ovary.

Aged↗
PubMed1991

Volvulus of the splenic flexure: radiographic features.

Six cases of splenic flexure volvulus were studied over a 14-year period. The patients were aged 15-62 years. Five of the six patients were mentally retarded, lifelong residents of a long-term-care institution. Two patients had congenital absence of normal colonic attachments; the other four patients had elongated mesocolons, presumably from chronic constipation. All patients underwent abdominal radiography, followed by a barium enema study. In the appropriate clinical setting, radiographic diagnosis of a splenic flexure volvulus is suggested when the following are seen: (a) a markedly dilated, air-filled colon wtih an abrupt termination at the anatomic splenic flexure; (b) two widely separated air-fluid levels, one in the transverse colon and the other in the cecum; (c) an empty descending and sigmoid colon; and (d) a characteristic beak at the anatomic splenic flexure at a barium enema examination.

Adult↗
PubMed2000

[Carcinoma of the colon invading the duodenum and pancreas].

In the submitted case-history the authors present the case of a 60-year-old woman with an extensive tumour of the transverse colon penetrating into the duodenum and head of the pancreas with an intimate relation to the upper mesenteric vein. An extensive curative en bloc resection included right-sided hemicolectomy, hemi-pancreatoduodenectomy and partial parietal resection of the upper mesenteric vein. The pathologist identified in the resected tissue a medium differentiated adenocarcinoma of the large intestine damaging the head of the pancreas and infiltrating the duodenal wall. The lymph nodes were negative and no metastatic affections were revealed. The postoperative course was without serious complications. The few cases of this type reported in the literature illustrate the possibility of successful resection and thus a substantially improved prognosis of the affected patient.

Adenocarcinoma↗