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

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Surgical Oncology

Case description

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.


 


 

tags: Segmental Gastric Resection surgical technique surgical video case transversectomy HEPATECTOMY Diaphragm pericardium Transverse Colon Adenocarcinoma case report surgery hematochezia clinical videos distended abdomen stenotic transverse colon tumor greater curvature parietal epigastric peritoneum partial left diaphragm pericardium adhesion gastro-gastroanastomosis left phrenoraphy left pleurostomy pericardium reconstruction proximal end colostomy colonic adenocarcinoma eLearning surgery


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