Four cases of laparoscopic colectomy for sigmoid colon and rectal cancer with persistent descending mesocolon
Abstract Background Persistent descending mesocolon (PDM) is a congenital anomaly associated with the failure of fixation of the descending colon to the lateral abdominal wall. In the laparoscopic colectomy for colorectal cancer, it has been noticed that there are extensive adhesions and a distincti...
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| Format: | Article |
| Language: | English |
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SpringerOpen
2020-10-01
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| Series: | Surgical Case Reports |
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| Online Access: | http://link.springer.com/article/10.1186/s40792-020-00988-6 |
| _version_ | 1828872370723487744 |
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| author | Yumi Furuichi Kensuke Kumamoto Eisuke Asano Akihiro Kondo Jun Uemura Hironobu Suto Minoru Oshima Takayoshi Kishino Hisashi Usuki Keiichi Okano Yasuyuki Suzuki |
| author_facet | Yumi Furuichi Kensuke Kumamoto Eisuke Asano Akihiro Kondo Jun Uemura Hironobu Suto Minoru Oshima Takayoshi Kishino Hisashi Usuki Keiichi Okano Yasuyuki Suzuki |
| author_sort | Yumi Furuichi |
| collection | DOAJ |
| description | Abstract Background Persistent descending mesocolon (PDM) is a congenital anomaly associated with the failure of fixation of the descending colon to the lateral abdominal wall. In the laparoscopic colectomy for colorectal cancer, it has been noticed that there are extensive adhesions and a distinctive anatomy of colonic vessels in cases with PDM. Therefore, it is necessary to have sufficient knowledge about PDM so that it can be appropriately treated during surgery. Case presentation Case 1—a 79-year-old man underwent laparoscopic intersphincteric resection for rectal cancer. Preoperative barium enema (BE) revealed that the sigmoid colon was located at the right side of the abdomen. An enhanced computed tomography (CT) showed that the common trunk of the left colic artery (LCA) and the first sigmoid colonic artery (S1) branched from the inferior mesenteric artery (IMA). Case 2—a 68-year-old man underwent laparoscopic sigmoidectomy for sigmoid colon cancer and laparoscopic distal gastrectomy for gastric cancer synchronously. BE showed that the descending colon ran from the splenic flexure to medial caudal side. An enhanced CT showed that the distance from the LCA to the marginal artery was 1.0 cm. Case 3—a 68-year-old man underwent laparoscopic low anterior resection for rectal cancer. BE showed that the descending colon ran to the medial caudal side. An enhanced CT showed that the mesentery of the descending colon was comparatively shortened. Case 4—a 60-year-old man underwent laparoscopic sigmoidectomy for sigmoid colon cancer. An enhanced CT showed that the descending colon ran to the medial caudal side and predicted that the LCA and S1 formed a common trunk and branched radially from the IMA. We reported four cases with PDM recognized preoperatively as above. Three cases had a shortening of the mesocolon. While dissecting the vessels, although special attention was required to maintain the blood flow to the intestine, none of these cases developed any complications during the postoperative course. Conclusions We considered that it is important to have positional awareness of the LCA and the marginal artery to perform the laparoscopic surgery safely when a colorectal cancer with PDM is diagnosed preoperatively using imaging methods. |
| first_indexed | 2024-12-13T06:52:30Z |
| format | Article |
| id | doaj.art-907cf46162cc4d80bf267eac51ae20d9 |
| institution | Directory Open Access Journal |
| issn | 2198-7793 |
| language | English |
| last_indexed | 2024-12-13T06:52:30Z |
| publishDate | 2020-10-01 |
| publisher | SpringerOpen |
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| series | Surgical Case Reports |
| spelling | doaj.art-907cf46162cc4d80bf267eac51ae20d92022-12-21T23:56:06ZengSpringerOpenSurgical Case Reports2198-77932020-10-01611710.1186/s40792-020-00988-6Four cases of laparoscopic colectomy for sigmoid colon and rectal cancer with persistent descending mesocolonYumi Furuichi0Kensuke Kumamoto1Eisuke Asano2Akihiro Kondo3Jun Uemura4Hironobu Suto5Minoru Oshima6Takayoshi Kishino7Hisashi Usuki8Keiichi Okano9Yasuyuki Suzuki10Department of Gastroenterological Surgery, Faculty of Medicine, Kagawa UniversityDepartment of Gastroenterological Surgery, Faculty of Medicine, Kagawa UniversityDepartment of Gastroenterological Surgery, Faculty of Medicine, Kagawa UniversityDepartment of Gastroenterological Surgery, Faculty of Medicine, Kagawa UniversityDepartment of Gastroenterological Surgery, Faculty of Medicine, Kagawa UniversityDepartment of Gastroenterological Surgery, Faculty of Medicine, Kagawa UniversityDepartment of Gastroenterological Surgery, Faculty of Medicine, Kagawa UniversityDepartment of Gastroenterological Surgery, Faculty of Medicine, Kagawa UniversityDepartment of Gastroenterological Surgery, Faculty of Medicine, Kagawa UniversityDepartment of Gastroenterological Surgery, Faculty of Medicine, Kagawa UniversityDepartment of Gastroenterological Surgery, Faculty of Medicine, Kagawa UniversityAbstract Background Persistent descending mesocolon (PDM) is a congenital anomaly associated with the failure of fixation of the descending colon to the lateral abdominal wall. In the laparoscopic colectomy for colorectal cancer, it has been noticed that there are extensive adhesions and a distinctive anatomy of colonic vessels in cases with PDM. Therefore, it is necessary to have sufficient knowledge about PDM so that it can be appropriately treated during surgery. Case presentation Case 1—a 79-year-old man underwent laparoscopic intersphincteric resection for rectal cancer. Preoperative barium enema (BE) revealed that the sigmoid colon was located at the right side of the abdomen. An enhanced computed tomography (CT) showed that the common trunk of the left colic artery (LCA) and the first sigmoid colonic artery (S1) branched from the inferior mesenteric artery (IMA). Case 2—a 68-year-old man underwent laparoscopic sigmoidectomy for sigmoid colon cancer and laparoscopic distal gastrectomy for gastric cancer synchronously. BE showed that the descending colon ran from the splenic flexure to medial caudal side. An enhanced CT showed that the distance from the LCA to the marginal artery was 1.0 cm. Case 3—a 68-year-old man underwent laparoscopic low anterior resection for rectal cancer. BE showed that the descending colon ran to the medial caudal side. An enhanced CT showed that the mesentery of the descending colon was comparatively shortened. Case 4—a 60-year-old man underwent laparoscopic sigmoidectomy for sigmoid colon cancer. An enhanced CT showed that the descending colon ran to the medial caudal side and predicted that the LCA and S1 formed a common trunk and branched radially from the IMA. We reported four cases with PDM recognized preoperatively as above. Three cases had a shortening of the mesocolon. While dissecting the vessels, although special attention was required to maintain the blood flow to the intestine, none of these cases developed any complications during the postoperative course. Conclusions We considered that it is important to have positional awareness of the LCA and the marginal artery to perform the laparoscopic surgery safely when a colorectal cancer with PDM is diagnosed preoperatively using imaging methods.http://link.springer.com/article/10.1186/s40792-020-00988-6Persistent descending mesocolonLaparoscopic colectomyAbnormal fixation |
| spellingShingle | Yumi Furuichi Kensuke Kumamoto Eisuke Asano Akihiro Kondo Jun Uemura Hironobu Suto Minoru Oshima Takayoshi Kishino Hisashi Usuki Keiichi Okano Yasuyuki Suzuki Four cases of laparoscopic colectomy for sigmoid colon and rectal cancer with persistent descending mesocolon Surgical Case Reports Persistent descending mesocolon Laparoscopic colectomy Abnormal fixation |
| title | Four cases of laparoscopic colectomy for sigmoid colon and rectal cancer with persistent descending mesocolon |
| title_full | Four cases of laparoscopic colectomy for sigmoid colon and rectal cancer with persistent descending mesocolon |
| title_fullStr | Four cases of laparoscopic colectomy for sigmoid colon and rectal cancer with persistent descending mesocolon |
| title_full_unstemmed | Four cases of laparoscopic colectomy for sigmoid colon and rectal cancer with persistent descending mesocolon |
| title_short | Four cases of laparoscopic colectomy for sigmoid colon and rectal cancer with persistent descending mesocolon |
| title_sort | four cases of laparoscopic colectomy for sigmoid colon and rectal cancer with persistent descending mesocolon |
| topic | Persistent descending mesocolon Laparoscopic colectomy Abnormal fixation |
| url | http://link.springer.com/article/10.1186/s40792-020-00988-6 |
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