• Clinical Endoscopy
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• v.57 no.4
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• pp.424-433
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• 2024

Colonic stent placement is a commonly used bridging strategy for surgery in patients with obstructive colorectal cancer. The procedure involves the placement of a self-expandable metallic stent (SEMS) across the obstructive lesion to restore intestinal patency and alleviate the symptoms of obstruction. By allowing patients to receive surgery in a planned and staged manner with time for preoperative optimization and bowel preparation, stent placement may reduce the need for emergency surgery, which is associated with higher complication rates and poorer outcomes. This review focuses on the role of colon stenting as a bridge to surgery in the management of obstructive colorectal cancer. SEMS as a bridge to surgery for left-sided colon cancer has been demonstrated to be particularly useful; however, further research is needed for its application in cases of right-sided colon cancer. Colon stent placement also has limitations and potential complications including stent migration, re-obstruction, and perforation. However, the timing of curative surgery after SEMS placement remains inconclusive. Considering the literature to date, performing surgery at an interval of approximately 2 weeks is considered appropriate. Therefore, colonic stent placement may be an effective strategy as a bridge to surgery in patients with obstructive colorectal cancer.

• Journal of Gastric Cancer
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• v.15 no.4
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• pp.286-289
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• 2015

It is well known that gastrectomy with curative intent is the best way to improve outcomes of patients with remnant gastric cancer. Recently, several investigators reported their experiences with laparoscopic gastrectomy of remnant gastric cancer. We report the case of an 83-year-old female patient who was diagnosed with remnant gastric cancer with obstruction. She underwent an entirely laparoscopic distal gastrectomy with colectomy because of direct invasion of the transverse colon. The operation time was 200 minutes. There were no postoperative complications. The pathologic stage was T4b (transverse colon) N0M0. Our experience suggests that laparoscopic surgery could be an effective method to improve the surgical outcomes of remnant gastric cancer patients.

• Journal of Veterinary Clinics
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• v.27 no.1
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• pp.113-116
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• 2010

A 6-years-old 30 kg male Germen Shepherd dog was presented with the history of abdominal pain, intermittent vomiting and anorexia. Abdominal survey radiography and ultrasonography revealed marked colonic distention. Positive contrast radiography revealed a colonic obstruction between the transverse colon and descending colon. Foreign bodies were identfied during colonoscopy. The descending colon was inflated by the air of endocope then foreign bodies were moved to the descending colon. Foreign bodies were removed by the enema. The dog's clinical signs resolved following foreign body removal.

• Journal of Veterinary Clinics
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• v.33 no.3
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• pp.179-182
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• 2016

An 11-year-old castrated male Maltese had vomiting, diarrhea, and abdominal distension for over two weeks and weight loss for several months. Clinical laboratory studies were not remarkable. Abdominal radiographs showed severe dilated intestine with a gravel sign. Colon was empty with normal diameter in the pneumocolon study. On ultrasonographs, most small bowel loops were dilated without normal peristalsis and showed abnormal thin wall. Barium contrast study revealed remarkably delayed gastric emptying and transit time up to $6^{th}$ day. On exploratory laparotomy, there were no mechanical obstruction and extra-intestinal abnormalities except severe dilated small intestine. Chronic fibrosing lymphohistiocytic leiomyositis with atrophy of tunica muscularis in the small intestines and colon was identified through full thickness biopsy and histopathology. Therefore, primary myopathic chronic intestinal pseudo-obstruction was diagnosed. This dog is survival with symptomatic treatments for eight months.

• Journal of Digestive Cancer Research
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• v.9 no.2
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• pp.43-49
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• 2021

Background/Aims: Colonic stenting as a bridge to elective surgery is an alternative for emergency surgery in patients with acute malignant colonic obstruction. However, since its benefits are uncertain, we aimed to establish whether it has better clinical outcomes. Methods: The patients with acute malignant left-sided colon obstruction enrolled from January 2009 to December 2018 in National Health Insurance Service Ilsan Hospital. The patients were enrolled to undergo colonic stenting as a bridge to elective surgery or emergency surgery. The following oncological outcomes were assessed: incidence of complete remission, disease progression, local recurrence, and systemic recurrence. Results: Out of 40 patients, 33 received self-expanding metallic stent (SEMS) as a bridge-to-surgery, and 7 underwent emergency surgery. More stoma was made in case of emergency surgery with statistical significance (p < 0.001). There were no significant differences in complete remission rate in curable left-sided malignant colonic obstruction between SEMS as a bridge-to-surgery and emergency surgery. Complete remission was achieved for 3 patients (42.9%) in the non-stent group and 27 patients (81.8%) in the stent group. There was no statistically significant difference in oncologic outcomes between the two groups (p = 0.069). According to multi-variate analysis, advanced TNM stage, Adjuvant chemotherapy, and SEMS bridge-to-surgery were significantly associated with disease-free survival. Disease-free survival rate differed significantly between the two groups (p = 0.024). Conclusions: SEMS as a bridge-to-surgery might be an effective strategy and reduce stoma formation in acute malignant left-sided colon obstruction.

• Journal of Yeungnam Medical Science
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• v.33 no.1
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• pp.29-32
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• 2016

Most ingested foreign bodies pass readily throughout intestinal tract if they reach the stomach. In some cases, foreign bodies may be impacted behind a luminal constriction but are rare in colon. Here, we report the case of a 59-year-old man who did laparoscopic anterior resection due to sigmoid colon cancer 2 years ago and ischemic colitis was repeated on the anastomosis site. He initially presented with symptoms of abdominal pain 3 months before and melena 1 day before admission. Abdomen computerized tomography showed a 3.2 cm segment of luminal narrowing of the proximal colon involving upstream foreign material stasis. Sigmoidoscopic approaches revealed near complete obstruction on the anal verge of 20 cm and scope passing failed. Balloon dilatations were done on the obstruction site four times all and a foreign body impacted above the obstruction site was removed by an alligator without any complications. The foreign body removed looks like plastic or a shell, about 20 mm in size.

• Journal of Chest Surgery
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• v.15 no.2
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• pp.188-193
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• 1982

Between 1967 and 1980, a total of 99 patients with a benign stricture of esophagus, resulting from a chemical burn, underwent a reconstructive procedure in which various segments of colon were used to bridge the gap between the cervical esophagus and the stomach. There were 42 males and 57 females and most were in their twenties and thirties. The most frequent site of the stricture was upper 1/3 of the thoracic esophagus [48.5%] and the next most common site was the low cervical esophagus [23.2%]. In 89 cases, the right colon with or without the terminal ileum was used as the conduit in an isoperistaltic manner and in 10, the left colon was used in an antiperistaltic position, because the right colon was not suitable as the conduit. There was a higher incidence of regurgitation [90% vs 0%], leakage at cervical anastomosis [80% vs 27%] and stenosis at anastomotic site [70% vs 15%] in an antiperistaltic left colon anastomosis, as compared to isoperistaltic right colon anastomosis. This was felt to be due to the orad peristaltic motion of the transplanted colon which acted as a functional obstruction distal to the esophagocolic suture line, resulting in breakdown of the anastomosis, leakage and eventual stenosis at the site of anastomosis. In conclusion, colon is useful and effective conduit as an esophageal substitute. Either the right or the left colon can be used for this purpose, provided that it is placed in an isoperistaltic position to minimize some of the complications listed above.

• Korean Journal of Radiology
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• v.1 no.3
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• pp.169-171
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• 2000

In order to relieve mechanical obstruction caused by rectal carcinoma, a bare rectal stent was inserted in the sigmoid colon of a 70-year-old female. The procedure was successful, and for one month the patient made good progress. She then complained of abdominal pain, however, and plain radiographs of the chest and abdomen revealed the presence of free gas in the subdiaphragmatic area. Surgical findings showed that a spur at the proximal end of the bare rectal stent had penetrated the rectal mucosal wall. After placing a bare rectal stent for the palliative treatment of colorectal carcinoma, close follow-up to detect possible perforation of the bowel wall is necessary.

• Advances in pediatric surgery
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• v.4 no.1
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• pp.74-78
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• 1998

Early recognition and surgical treatment of Hirschsprung's disease prevents serious mortality and morbidity from enterocolitis and obstruction. Usually this disease is characterized by a single aganglionic segment of the colon extending distally to the anal margin. In surgical treatment, the surgeon performs a frozen section biopsy to confirm whether there are ganglion cells. If there are intervening ganglionic sites in aganglionic bowel, there may be confusion in diagnosis and treatment. The authors experienced one case of total colonic aganglionosis with skip area. A transverse loop colostomy was performed on a 7 day-old male baby with colon perforation due to Hirschsprung's disease. But intestinal obstruction persisted and required two more operations to find the true nature of the disease. There were aganglionic segments from the anal margin to the terminal ileum 3.7cm proximal to the ileocecal valve. The entire transverse colon and appendix were normally ganglionated.

• Journal of Veterinary Clinics
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• v.11 no.1
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• pp.437-470
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• 1994

These studies were performed to establish more effective surgical method for correcting congenital atresia coli in calves. Distal colon fistulation, proximal colon fistulation and colon anastomosis which could be applied for surgical repair of intestinal obstruction were carried out in goatlings experimentally and in calves with atresia coli clinically. After treatment of the animals clinical signs, blood component values, body weight gain, survival and necropsy findings were observed. In goatlings, clinical signs after colon fistulation were diarrhea, anorexia and vitality loss, and those of proximal colon fistulation group were severer than those of distal colon fistulation group. Surviviability after operation was 9~16 weeks in distal colon fistulation group, 2~8 weeks in proximal colon fistulation group, and 2-3 days in colocolic anastomosis group, respectively. There were no alterations in blood component values among experimental groups. Weight gain rates were 54.6% in distal colon fistulation group and 42.9% in proximal colon fistulation group compared with those of control. Necropsy findings observed in experimental groups were distension of intestine and excessive fluid in abomasum and intestine. Two calves with atresia coli died 1 day and 6 days after operation but one with colon fistulation survived more than two months. Preoperative clinical signs in calves with atresia coli were abdominal distension, progressive anorexia, no defecation and postoperative clinical signs wert diarrhea and periodic abdominal distension. After operation there were no alterations in blood component values between the calf with atresia coli and control calf. Weight gain rate of calf with atresia coli was similar to that of control but revealed the tendency to decrease from the 2nd month after operation. Necropsy findings observed in two calves with atresia coli were intestinal distension. intraluminal excessive fluid, blind atretic sac and absence of intrarectal content. It was concluded that proximal or distal colon fistulation could be available for surgical correction of congenital atresla coli and prognosis of distal colon fistulation was better than of proximal colon fistulation, but that extensive colocolic anastomosis could not be compatible with life in ruminants.