A Sciuto1, C Grifasi1, F Pirozzi2, P Leon1, R E M Pirozzi3, F Corcione4. 1. Department of General, Laparoscopic and Robotic Surgery, Azienda Ospedaliera Specialistica dei Colli - Monaldi Hospital, Via Leonardo Bianchi, 80131, Naples, NA, Italy. 2. Department of Abdominal Surgery, Casa Sollievo della Sofferenza Research Hospital, San Giovanni Rotondo, FG, Italy. 3. School of Medicine and Surgery, University of Naples Federico II, Naples, Italy. 4. Department of General, Laparoscopic and Robotic Surgery, Azienda Ospedaliera Specialistica dei Colli - Monaldi Hospital, Via Leonardo Bianchi, 80131, Naples, NA, Italy. francesco.corcione@ospedalideicolli.it.
Abstract
BACKGROUND: The Deloyers procedure, which includes inversion of the right colon around the axis of the ileocolic vessels, can be used to achieve a well vascularized, tension-free colorectal anastomosis after extended left colectomy. The aim of this study is to report our technique and outcome in a series of ten consecutive patients who underwent right colonic transposition by laparoscopic approach. METHODS: Charts were retrospectively reviewed to analyze postoperative outcome and bowel function. A video was recorded to demonstrate the procedure. RESULTS: Conversion was required in one (10%) patient due to extensive adhesions. No intraoperative complications were recorded. Anastomotic leakage occurred in one (10%) case and was managed with peritoneal lavage and ileostomy. Six months after surgery, all patients reported a median number of 2.5 (range 2-3) bowel movements per day with solid stool consistency. Neither anastomotic stricture nor bowel ischemia was found at 1-year endoscopic follow-up. CONCLUSION: Our experience shows that laparoscopic right colonic transposition is a safe and feasible procedure and provides good functional outcomes.
BACKGROUND: The Deloyers procedure, which includes inversion of the right colon around the axis of the ileocolic vessels, can be used to achieve a well vascularized, tension-free colorectal anastomosis after extended left colectomy. The aim of this study is to report our technique and outcome in a series of ten consecutive patients who underwent right colonic transposition by laparoscopic approach. METHODS: Charts were retrospectively reviewed to analyze postoperative outcome and bowel function. A video was recorded to demonstrate the procedure. RESULTS: Conversion was required in one (10%) patient due to extensive adhesions. No intraoperative complications were recorded. Anastomotic leakage occurred in one (10%) case and was managed with peritoneal lavage and ileostomy. Six months after surgery, all patients reported a median number of 2.5 (range 2-3) bowel movements per day with solid stool consistency. Neither anastomotic stricture nor bowel ischemia was found at 1-year endoscopic follow-up. CONCLUSION: Our experience shows that laparoscopic right colonic transposition is a safe and feasible procedure and provides good functional outcomes.
Entities:
Keywords:
Colorectal anastomosis; Deloyers procedure; Laparoscopic colorectal surgery; Left colectomy; Right colon transposition
Authors: K Otani; H Nozawa; T Kiyomatsu; K Kawai; K Hata; T Tanaka; T Nishikawa; K Sasaki; M Kaneko; K Murono; S Emoto; T Watanabe Journal: Tech Coloproctol Date: 2017-11-13 Impact factor: 3.781