Transversectomy En Bloc With Segmental Gastric Resection, Atypical 2-3 Hepatectomy and Partial Resection of the Diaphragm and Pericardium for a Locally Advanced Transverse Colon Adenocarcinoma

A 70-year old patient was investigated in our department for abdominal pain and hematochezia. Clinical examination revealed a distended abdomen and the blood analysis revealed a hemoglobin value of 7 g/dl. Colonoscopy revealed a stenotic transverse colon tumor and upper endoscopy revealed tumor invasion at the level of the greater curvature. 

The CT scan confirmed a locally advanced transverse colon tumor with gastric and liver invasion and parietal epigastric peritoneum, partial left diaphragm and pericardium adhesion.

A transverse colon resection en bloc with segmental gastrectomy, atypical segments 2-3 hepatectomy, partial resection of the anterior peritoneum, partial resection of the left diaphragm and partial resection of the pericardium.

The reconstructions were performed as follows: end to end gastro-gastroanastomosis, primary left phrenoraphy with left pleurostomy, pericardium reconstruction with vascular Hemagard substitution vascular patch and proximal end colostomy.

The final pathological examination revealed a colonic adenocarcinoma pT4bpN0 LV+ Pn+ R0. 

* The case was prezented as an e-poster during The National Conference of Surgery, Romania, Eforie mai 2023.