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At least 145 records · Page 8Linked to original sources
PubMed2005

Augmentation gastroplasty using a segment of transverse colon for corrosive gastric stricture.

BACKGROUND AND AIMS: Diffuse corrosive gastric stricture is a relatively rare entity, and gastric ablative procedures are traditionally recommended for it. We emphasize the importance of preservation of a cicatrized stomach and describe its augmentation using a segment of transverse colon. CASE REPORT AND PROCEDURE: A young female with a history of corrosive acid ingestion presented to our surgical unit with nonbilious vomiting following meals, consistent weight loss and features of gastric outlet obstruction. A barium study revealed a small-capacity stomach with pyloric stricture. We planned to augment the stomach capacity by using a segment of transverse colon. After documentation of a normal colon by barium examination, a 15-cm segment of transverse colon was harvested based on middle colic artery. This vascularized patch of bowel was united with the stomach that was opened up by a longitudinal incision made along the body. RESULT AND FINDING: A barium study on the tenth postoperative day revealed a good capacity and contour of the stomach and free entry of Barium into the small intestine. The patient is tolerating a normal meal and has no vomiting. At 3 months follow-up, the patient had a normal stomach radiologically and endoscopically, with a weight gain of 7 kg. CONCLUSIONS: Augmentation of corrosive gastric stricture by a segment of transverse colon is an innovative, practical, and useful procedure, although long-term results are awaited.

Adolescent↗
PubMed1996

Transverse colon urinary diversion in gynecologic oncology.

OBJECTIVE: To describe and analyze the outcome of urinary conduits utilizing the transverse colon over an 11-year period. MATERIALS AND METHODS: All patients undergoing a urinary conduit on the gynecologic oncology service from 1983 to 1993 were identified and a retrospective review was conducted. RESULTS: Transverse colon urinary conduits (TCC) were performed in 86 patients. The majority of patients had a history of cervical cancer (81%), and all but one patient had prior pelvic radiotherapy. TCC was performed in conjunction with pelvic exenteration in 47 patients (55%) and alone as palliation for the effects of progressive malignancy in 10 patients (12%). Other indications for conduit construction included urinary fistulas (19%), ureteral or urethral obstruction (7%), conduit revision (5%), overflow incontinence (2%), or intraoperative ureteral injury (1%). Abnormal preoperative renal morphology was common (48%). A total of 165 ureterocolic anastomoses were performed. Ureteral stents and intestinal staplers were used routinely. The perioperative mortality rate was 3%. Loss of renal function occurred in 10 of 165 renal units (6%). Nineteen (22%) patients had partial ureteral obstruction managed by percutaneous nephrostomy or indwelling stents. Conduit reconstruction was undertaken in 7 patients (8%). Renal calculi were noted in 3 patients. Overall median survival was 30 months. CONCLUSION: The complications of TCC are similar to those experienced in other urinary diversions. No distinct advantage to using the transverse colon was observed. Management of progressive ureteral obstruction by conservative methods, such as percutaneous nephrostomy or ureteral stents, was frequent and provided a reasonable alternative to reoperation in the poor operative candidate.

Adult↗
PubMed1994

Transverse colon conduit urinary diversion in patients treated with very high dose pelvic irradiation.

OBJECTIVE: To study the results of transverse colon conduit urinary diversion in patients receiving very high dose pelvic irradiation (> or = 65 Gy). PATIENTS AND METHODS: Records were reviewed for 30 such patients who underwent transverse colon conduit as a primary form of urinary diversion between January 1986 and June 1992. Most of the conduits were constructed using refluxing ureterocolic anastomoses with stents. RESULTS: There was no operative mortality. Although the procedure was associated with a complication rate of 37% and a re-operation rate of 20%, there were no bowel or urinary anastomotic leaks. The operation could be safely performed on patients with renal failure, with 83% of such patients showing normal or improved serum creatinine levels post-operatively. CONCLUSION: The advantages of transverse colon conduit urinary diversion are the use of non-irradiated bowel and ureters for diversion. We recommend it as a primary form of urinary diversion in these high risk cases.

Adult↗
PubMed1994

Gastrocolic fistula originating from transverse colon cancer: report of a case and review of the Japanese literature.

A 72-year-old woman was admitted to our hospital complaining of loss of weight, general fatigue, and upper abdominal pain. Barium studies suggested that a fistula was present between the proximal transverse colon and the stomach which originated from a carcinoma of the colon. A plain computed tomography (CT) scan confirmed the presence of a gastrocolic fistula. A two-thirds distal gastrectomy and right hemicolectomy with a resection of a bulky tumor in the mesocolon were performed en bloc. Histological examination revealed a well-differentiated adenocarcinoma of the transverse colon which was involved with the wall of the stomach. We were able to obtain information on 14 previous cases of gastrocolic fistula originating from transverse colon cancer in the Japanese literature, including the present case. The most common symptom was abdominal pain (64%). A preoperative diagnosis of fistula was confirmed in 10 of the 11 cases examined by barium studies. A plain CT and a CT scan after the barium studies may also be helpful in detecting fistula formation. A fistula between the carcinoma of the middle or distal transverse colon and the stomach was found in 13 of 14 cases, but not in our case. Only one case lived longer than 9 years, even though a surgical resection was possible in 9 of 11 cases.

Adenocarcinoma↗
PubMed2001

Use of a segment of transverse colon as a gastric substitute after total gastrectomy: an audit of 18 patients.

BACKGROUND: Various types of reconstruction have been employed in attempts to improve the quality of life after total gastrectomy. The use of a jejunal pouch has been the most common approach, and preservation of the duodenal passage has been recommended in several related studies. The aim of the present study was to investigate the benefit of the use of a segment of transverse colon as a gastric substitute. METHODS: Isoperistaltic interposition with a segment of transverse colon was performed after total gastrectomy in 18 patients with gastric malignancies. To clarify the benefits and disadvantages of this technique, a comparison was made between these patients and another 17 patients who underwent jejunal interposition without a pouch. The parameters to be compared included operation time, amount of blood loss, incidence of postoperative complications, and changes in body weight. RESULTS: Postoperative complications were more frequent in the patients reconstructed with the transverse colon, despite a lower incidence of extended lymphadenectomies in this group of patients. No advantage over those treated by the jejunal interposition, in terms of postoperative body weight, was evident during 2 years of follow-up. CONCLUSION: Although it may be too early to draw definite conclusions, there seems to be little benefit in the use of the transverse colon as a gastric substitute.

Carcinoma↗
PubMed2005

Asymptomatic tubular duplication of the transverse colon in an adult.

Colonic duplication is a rare congenital anomaly of the alimentary tract. In most cases, symptomatic duplications of the colon are recognized and treated by childhood. It is uncommon for these lesions to be detected in the adulthood since they present with vague symptoms if at all. We experienced a case of asymptomatic tubular duplication of the transverse colon in a 40-year-old female. Barium enema revealed a tubular duplication of the transverse colon. The duplicated segment arose from the mid ascending colon and incorporated just proximal to the splenic flexure, running parallel to the transverse colon and communicating with it at both ends. Colonoscopy demonstrated a normal colonic mucosa in the duplicated segment. The diameter of its lumen gradually narrowed proximally and the colonoscope could not be passed through the proximal opening of the segment. The patient did not need any treatment. Duplications of the alimentary tract can be found at any age. The possibility of congenital lesions in the adult population should not be overlooked.

Adult↗