Background: The concept of Complete Mesocolic Excision(CME) as a surgical techniquefor colonic carcinoma.was first introduced in the west in 2008. CME follows the sameprinciple as Total MesorectalExcision(TME) in rectal carcinoma. We have adopted this newtechnique since 2014.
Objective: Here we describe the CME technique in open and laparoscopic right hemicolectomy,and our initial experience of the surgery.
Methods: This is a prospective observational study. Data collected from 24 patientsadmitted under our care in BIR DEM General Hospital from January 2015 to January 2017with carcinoma caecum or ascending colon.
Results: Out of 24 patients 14 patients opted for laparoscopic right hemicolectomy and 10patients choose open right hemicolectomy. In laparoscopic right hemicolectomy with CMEthe mean operating time was 152 minutes, amount of blood loss ranges 70-100ml.Number of lymphnodes removed enbloc with specimen 25-30(mean27). Distance oftumor from mesenteric margins at the point of vascular tie 11-15 cm. In open righthemicolectomy with CME mean operating time was 142 minutes, estimated blood loss120-300 ml, harvested lymph nodes within mesocolic envelop 24-31(mean27), anddistance of tumor from vascular tie is 9-15 cm. there is one major complication of uretericinjury. Histopathology shows resection margin are free of tumor in all except 2 cases.
Conclusion: Right hemicolectomy with CME in both open and laparoscopic approach canbe easily adopted by general surgeons and colorectal surgeons who are performing'standard technique' or 'conventional technique' routinely for right hemicolectomy. Withthe encouraging results available from centers who are routinely performing CME incolonic surgery it is now considered as the new bench mark of quality of standard colonicsurgery.
Journal of Surgical Sciences (2017) Vol. 21 (1) :15-18
Congenital absence of the vermiform appendix is a rare condition in human that many well-experienced surgeons have never seen. The fact that congenital absence of the vermiform appendix has been reported on several occasions confirms its existence and should be kept in mind. A thorough and meticulous search of the entire ileocecal region and mobilization of the cecum and ascending colon should be carried out before the diagnosis is made. But, it should also be kept in mind that early cessation of appendiceal anlage can result in very tiny ones. DOI: http://dx.doi.org/10.3329/bccj.v1i2.17207 Bangladesh Crit Care J September 2013; 1 (2): 109-110
Adult colorectal intussusception is a relatively rare condition. It is different from that of a child in that, most cases have an organic etiology like a malignant or benign neoplasm. This is a 40 year female patient presenting with passage of blood and mucous per rectum later diagnosed as sigmoidorectal intussusception due to submucous lipoma in sigmoid colon that was protruding through anus giving the appearance of a large polypoid rectal growth.
Gastro Intestinal Stromal Tumor (GIST) are a type of neoplasm arising from the embryological mesoderm of GastroIntestinal Tract. But they can also arise from extra intestinal sites. The incidence1 of site of origin of GIST is - Oesophagus 5% Stomach 50% Small intestine 25% Colon & rectum 10%, Extr-intestinal (Mesenchyme, GB,Pancreas) 10%.We present here a case of GIST attaining enormous size, having all classical histological features of GIST arising from the mesentery which is a relatively rare site. Birdem Med J 2013; 3(1): 47-49 DOI: http://dx.doi.org/10.3329/birdem.v3i1.17127
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