A 46-year old man presented with lower right quadrant abdominal pain caused by abdominal trauma. Abscess drainage was performed after the diagnosis of retroperitoneal abscess in the ileocecal portion of the colon. Type 2 advanced cancer was found in the cecum and ascending colon. Surgery was performed after improvement of inflammation. Considering the difficulty of curative resection for retroperitoneal invasion, we first performed ileo-transverse colon anastomosis. After surgery, the patient received FOLFOX with panitumumab(Pmab)as neoadjuvant chemotherapy. After 6 courses of this regimen, contrast enhanced computed tomography revealed shrinkage of the tumor. We performed a second surgery but the tumor was unresectable because of retroperitoneal invasion. After 47 courses of chemotherapy(5-FU plus LV with Pmab), the tumor was stable and we observed no distant metastasis. A third surgery was performed, and we were able to perform ileocecal resection including the retroperitoneum. The pathological diagnosis was pT4b(SI), pN1, ly2, V2, pPM0, pDM0, R0, pStage III a. On histological examination, the efficacy of chemotherapy was evaluated as Grade 1a. The patient received adjuvant chemotherapy with capecitabine and remains healthy without any evidence of recurrence more than 10 months after surgery.
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Clin Endosc
November 2024
Department of Gastroenterology, Sheffield University Hospitals NHS Trust, Sheffield, United Kingdom.
Post-endoscopic mucosal resection (EMR) bleeding, or clinically significant post-EMR bleeding, is influenced by factors such as polyp size, right-sided colonic lesions, laterally spreading tumors, anticoagulant use, and comorbidities like cardiovascular or chronic renal disease. The optimal prophylactic therapy for post-EMR bleeding remains unknown, with no consensus on specific criteria for its application. Moreover, prophylactic measures, including clipping, suturing, and coagulation, have produced mixed results.
View Article and Find Full Text PDFAn 80-year-old woman with epigastric pain and weight loss presented to our hospital with cancer of the ascending colon and cholelithiasis. Initially hospitalized for a suspected gallstone attack, she later developed gangrenous cholecystitis. She underwent a laparoscopic cholecystectomy, which revealed abscess formation and necrosis extending into the gallbladder duct.
View Article and Find Full Text PDFGan To Kagaku Ryoho
December 2024
Dept. of Surgery, Owase General Hospital.
A 61-year-old woman underwent an open right hemicolectomy for perforated ascending colon cancer. Later, the patient underwent R2 surgery for duodenal invasion. Chemotherapy was initiated with mFOLFOX6 and panitumumab post-surgery.
View Article and Find Full Text PDFTech Coloproctol
December 2024
Department of Faculty Surgery No. 2, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia.
Background: Reduced-port laparoscopic surgery (RPLS) uses the minimum possible number of ports or small-sized ports in laparoscopic surgery. The combination of RPLS and natural orifice specimen extraction (NOSE) minimizes the procedural damage.
Methods: A total of 17 patients diagnosed with right colon cancer were included: 5 patients in the RPLS + NOSE group and 12 patients in the conventional laparoscopic surgery (CL) + mini-laparotomy (ML) group.
Crohn's disease (CD) is a complex inflammatory bowel disease resulting from an interplay of genetic, microbial, and environmental factors. Cell-type-specific contributions to CD etiology and genetic risk are incompletely understood. Here we built a comprehensive atlas of cell-type- resolved chromatin accessibility comprising 557,310 candidate cis-regulatory elements (cCREs) in terminal ileum and ascending colon from patients with active and inactive CD and healthy controls.
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