VRAM flap reconstruction of the perineum is associated with an increased wound healing rate and may protect against pelvic abscess development. However, procedure-related long-term morbidity is incompletely studied and the procedure should be reserved for selected patients.
RCA occurs in 54% patients, passes over the SMV in 92.6% specimens and leaves a 22.7 mm stump. ICA passes under the SMV in most cases, leaving a 15.4 mm stump. These data could be of crucial importance to the surgeon facing laparoscopic right colectomy for cancer.
Anatomically correct D3 resection implies posterior vertical compartment removal with posterior ileocolic artery crossing. Addition of the lateral vertical compartment to routine right colectomy has an improvement potential of 5 to 6 nodes.
An early postoperative CT can show arterial stumps after right colectomy for cancer. These stumps appear to be significantly longer than presumed; implying a significant improvement potential when specimen size is concerned.
In cases with contained perforation, conservative treatment gives satisfactory results, laparoscopy with lavage and drainage can be attempted and continued with a conservative course.
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