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Post-polypectomy colorectal bleeding: current strategies and the way forward.
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 PDFOncological and Clinical Impacts of Routine Splenic Flexure Mobilization in Anterior Resection.
Cureus
November 2024
Colorectal Surgery, The Royal Wolverhampton NHS Trust, Wolverhampton, GBR.
Background Splenic flexure mobilization (SFM) is widely regarded as one of the most challenging steps in laparoscopic and robotic colorectal surgery, sparking ongoing debate. Some surgeons routinely advocate for SFM, citing its role in achieving greater left colonic reach, which facilitates a safe, tension-free, and well-vascularized anastomosis while adhering to oncological principles. Conversely, others argue that SFM does not consistently ensure these benefits and may increase the risk of complications, including splenic, bowel, or vascular injuries, as well as unnecessarily prolonging the procedure.
View Article and Find Full Text PDFSplenic flexure mobilization: does body topography matter?
Tech Coloproctol
December 2024
Department of General Surgery, Istanbul Medipol University, TEM Avrupa Otoyolu Cıkışı No:1 Bagcilar, 34214, Istanbul, Turkey.
Background: Splenic flexure mobilization can be technically challenging, and its oncological benefits remain uncertain. This study aims to explore the relationship between patient and clinical characteristics and splenic flexure mobilization time as well as the implications of prolonged splenic flexure mobilization duration.
Methods: This retrospective cohort study includes 105 patients who underwent laparoscopic distal colorectal cancer surgery between 2013 and 2018.
Feculent Drainage from Percutaneous Endoscopic Gastrostomy Tube due to Gastrocolocutaneous Fistula Found in Emergency Department: A Case Report.
Clin Pract Cases Emerg Med
November 2024
Loma Linda University Medical Center, Department of Emergency Medicine, Loma Linda, California.
Introduction: Percutaneous endoscopic gastrostomy (PEG) placement is a common procedure for patients requiring non-oral feeding. One rare complication of PEG placement is the formation of a gastrocolocutaneous fistula that develops when the bowel is caught between the stomach and abdominal wall during placement. This report explores an elderly patient's gastrocolocutaneous fistula development months post-PEG placement who presented with malodorous leakage from the gastrostomy tube to the emergency department (ED).
View Article and Find Full Text PDFLaparoscopic Intraperitoneal Onlay Mesh Repair for Symptomatic Secondary Lumbar Hernia After Retroperitoneoscopic Nephrectomy: A Case Report.
Cureus
December 2024
Gastroenterological Surgery, Tohoku Medical and Pharmaceutical University, Sendai, JPN.
Lumbar hernia (LH) is a rare abdominal wall hernia that occurs within the anatomic boundaries of the 12th rib, iliac crest, external oblique muscles, erector spinae muscles, and vertebral column. Secondary LH after urological surgery is rare, and the limited evidence hinders consensus on optimal surgical treatment. Here, we present a case of laparoscopic intraperitoneal onlay mesh (IPOM) repair for a large, symptomatic secondary LH after retroperitoneoscopic nephrectomy (RN) with mid-term postoperative outcomes.
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