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Yamamoto T, Fukuda M, Okuchi Y, Hisano K, Tanaka E, Terajima H. Cranial-First Approach for Splenic Flexure Colon Cancer in Laparoscopic Complete Mesocolic Excision. Dis Colon Rectum 2023; 66:e218-e219. [PMID: 36856686 DOI: 10.1097/dcr.0000000000002489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Affiliation(s)
- Takehito Yamamoto
- Department of Gastroenterological Surgery and Oncology, Medical Research Institute Kitano Hospital, Osaka, Japan
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Kobayashi R, Ogura A, Kawai S, Takagi K, Kawai K, Maeda T, Aritake T, Nagano N, Kamiya S. Cranial-first approach for safe laparoscopic surgery in right-sided colon cancer. Tech Coloproctol 2020; 24:489-490. [PMID: 32040780 DOI: 10.1007/s10151-020-02158-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Accepted: 02/05/2020] [Indexed: 10/25/2022]
Affiliation(s)
- Ryutaro Kobayashi
- Department of Surgery, Tsushima City Hospital, Tsushima City, Aichi, Japan
| | - Atsushi Ogura
- Department of Surgery, Tsushima City Hospital, Tsushima City, Aichi, Japan. .,Division of Gastrointestinal Surgery, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.
| | - Satoru Kawai
- Department of Surgery, Tsushima City Hospital, Tsushima City, Aichi, Japan
| | - Kenji Takagi
- Department of Surgery, Tsushima City Hospital, Tsushima City, Aichi, Japan
| | - Kiyotaka Kawai
- Department of Surgery, Tsushima City Hospital, Tsushima City, Aichi, Japan
| | - Takashi Maeda
- Department of Surgery, Tsushima City Hospital, Tsushima City, Aichi, Japan
| | - Tsukasa Aritake
- Department of Surgery, Tsushima City Hospital, Tsushima City, Aichi, Japan
| | - Natsuki Nagano
- Department of Surgery, Tsushima City Hospital, Tsushima City, Aichi, Japan
| | - Satoaki Kamiya
- Department of Surgery, Tsushima City Hospital, Tsushima City, Aichi, Japan
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Ogura A, Kobayashi R, Kawai S, Takagi K, Kawai K, Maeda T, Aritake T, Nagano N, Kamiya S. Cranial-first approach of laparoscopic left colectomy for T4 descending colon cancer invading the Gerota's fascia. Surg Case Rep 2019; 5:159. [PMID: 31659502 PMCID: PMC6816766 DOI: 10.1186/s40792-019-0720-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Accepted: 09/27/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The safety and feasibility of laparoscopic colectomy for T4 colorectal cancer remain controversial. We believe that setting a "Goal" that will guide the surgeons in returning from the deep layer could be the key to safe en bloc resection of neighboring organs. For descending colon cancer, the cranial-first approach makes it possible to clearly visualize the pancreas and origin of the transverse mesocolon, leading to safe splenic flexure mobilization and complete mesocolic excision, which is the strongest advantage of this approach. CASE PRESENTATION A 75-year-old woman was diagnosed with T4 descending colon cancer invading the Gerota's fascia. We performed laparoscopic left colectomy using the cranial-first approach to set a "Goal" at the inferior border of the pancreas for safe resection of the Gerota's fascia. The total operative time was 233 min, and the estimated blood loss was 98 ml. She was discharged after surgery without postoperative complications. Pathological findings revealed the invasion into the Gerota's fascia, and the resection margin was negative for cancer. CONCLUSIONS The cranial-first approach of laparoscopic left colectomy appears to be safe and feasible and could be a promising method for selected patients with T4 descending colon cancer invading the Gerota's fascia.
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Affiliation(s)
- Atsushi Ogura
- Department of Surgery, Tsushima City Hospital, 3-73, Tachibana Town, Tsushima City, Aichi, 496-8537, Japan.
| | - Ryutaro Kobayashi
- Department of Surgery, Tsushima City Hospital, 3-73, Tachibana Town, Tsushima City, Aichi, 496-8537, Japan
| | - Satoru Kawai
- Department of Surgery, Tsushima City Hospital, 3-73, Tachibana Town, Tsushima City, Aichi, 496-8537, Japan
| | - Kenji Takagi
- Department of Surgery, Tsushima City Hospital, 3-73, Tachibana Town, Tsushima City, Aichi, 496-8537, Japan
| | - Kiyotaka Kawai
- Department of Surgery, Tsushima City Hospital, 3-73, Tachibana Town, Tsushima City, Aichi, 496-8537, Japan
| | - Takashi Maeda
- Department of Surgery, Tsushima City Hospital, 3-73, Tachibana Town, Tsushima City, Aichi, 496-8537, Japan
| | - Tsukasa Aritake
- Department of Surgery, Tsushima City Hospital, 3-73, Tachibana Town, Tsushima City, Aichi, 496-8537, Japan
| | - Natsuki Nagano
- Department of Surgery, Tsushima City Hospital, 3-73, Tachibana Town, Tsushima City, Aichi, 496-8537, Japan
| | - Satoaki Kamiya
- Department of Surgery, Tsushima City Hospital, 3-73, Tachibana Town, Tsushima City, Aichi, 496-8537, Japan
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