With regard to wound infection rates, the CSWA method was better than the conventional method, although this was found to be borderline significant. With regard to patient satisfaction, the CSWA method proved to be superior to the conventional method, and this was found to be statistically significant. In addition, the technique is applicable to all forms of stoma regardless of the bowel segment involved, trephine size, and indication for diversion.

This is a case of a 75-year-old man who presented with a 7-month history of a reducible rectal mass. The patient came to the emergency department with a prolapsed necrotic bowel involving a strangulated segment with the rectal mass. He underwent an abdominotransanal resection through a combined abdominal and perineal approach. His postoperative course was unremarkable. Histopathological and immunohistochemical studies showed a rectal carcinosarcoma. Because of a state-mandated lockdown due to the COVID-19 pandemic, the patient failed to follow-up. He was later seen to have metastatic progression. Owing to the poor functional status of the patient, the shared decision of the multidisciplinary team, the patient and his family was to manage him with palliative intent.

Highlights The stomach is a frequent choice for esophageal reconstruction due to its robust blood supply. Surgical management of esophageal cancer is complex, not only from the standpoint of extirpation of the primary tumor and the regional lymph nodes, but also in regards to esophageal replacement to re-establish intestinal continuity. The use of indocyanine green (ICG) fluorescence angiography is a feasible and promising adjunct to evaluate adequacy of perfusion of the gastric conduit for esophageal replacement. ICG fluorescence angiography can aid in choosing the most appropriate site of anastomosis to prevent ischemia-related complications such as leakage or stricture.

BACKGROUND: The Philippines ranks 10th in tuberculosis prevalence worldwide. Aside from pulmonary tuberculosis, GI tuberculosis remains an important cause of morbidity and mortality, particularly in endemic areas. OBJECTIVE: This study aimed to describe the clinicopathologic profile and surgical outcomes of patients with GI tuberculosis. DESIGN: Retrospective descriptive study. SETTING: Department of Surgery at the Philippine General Hospital, Manila, Philippines. PATIENTS: This study included all newly diagnosed cases of GI tuberculosis from January 1, 2009, to December 31, 2019. MAIN OUTCOME MEASURES: Clinical response to surgery. RESULTS: A total of 241 confirmed new cases were managed during an 11-year period. Of these, 208 patients (86.30%) underwent outright surgery, whereas the remaining patients (13.69%) received antituberculous therapy. Fifteen medically managed patients eventually required surgery, bringing the total surgically managed patients to 223. The patients’ age ranged from 19 to 72 years, with a 1.9:1 male to female ratio. The most common complaint was abdominal pain. Intestinal obstruction was the most common indication for surgery. A right hemicolectomy was the most often performed procedure, with the ileocecal area as the most frequently involved segment. The most common histopathologic findings were epithelioid granuloma and caseation necrosis. Postoperative length of stay ranged from 0 to 59 days (mean, 7 days). Morbidity rate was 5.38% and mortality rate was 3.14%. Four deaths were operative and resulted from septic shock because of hollow viscus perforation. LIMITATIONS: This study was limited to histopathologic basis for diagnosis. CONCLUSION: The recommended initial therapy for all forms of extrapulmonary tuberculosis is a 6-month regimen of antituberculous therapy unless the organisms are known or suspected to be resistant to first-line drugs. Surgery is reserved for complications of intra-abdominal tuberculosis: obstruction, perforation, or severe bleeding. Timely surgical intervention, coupled with medical management led to the best outcomes for these patients. See Video Abstract at http://links.lww.com/DCR/C56. MANEJO QUIRÚRGICO DE PACIENTES CON TUBERCULOSIS GASTROINTESTINAL ANTECEDENTES: Las Filipinas ocupa el décimo lugar en prevalencia de tuberculosis en todo el mundo. Aparte de la tuberculosis pulmonar, la tuberculosis gastrointestinal sigue siendo una causa importante de morbilidad y mortalidad, especialmente en las zonas endémicas. OBJETIVO: Este estudio tuvo como objetivo describir el perfil clinicopatológico y los resultados quirúrgicos de pacientes con tuberculosis gastrointestinal. DISEÑO: Estudio descriptivo retrospectivo. AJUSTE: Departamento de Cirugía del Hospital General de Filipinas, Manila, Filipinas. PACIENTES: Todos los casos de tuberculosis gastrointestinal recién diagnosticados desde el 1 de Enero del 2009 hasta el 31 de Diciembre del 2019. MEDIDAS DE RESULTADO PRINCIPAL: Respuesta clínica a la cirugía. RESULTADOS: Se manejaron un total de 24...

We document a case of a 24-year-old gravida 2, para 1 (1001), on her second trimester, who was referred to the surgical oncology service for a palpable right hemiabdominal mass. She previously underwent wide excision of a retroperitoneal atypical lipomatous tumour 2 years ago. Her current case was successfully managed by a multidisciplinary team of doctors from the preoperative phase, the actual surgery up to the adjuvant treatment. She had a two-staged surgery: an elective lower-segment caesarean section at 34 weeks age of gestation for which she delivered a healthy baby girl and, 2 weeks after, she had excision of the huge retroperitoneal tumour recurrence. Histopathology revealed a 35 cm×25 cm×22 cm dedifferentiated liposarcoma, for which she was started on adjuvant systemic chemotherapy.

No abstract

We present a 45-year-old female with a 20-year history of abdominopelvic pain during menstruation and a gradually enlarging abdominal mass. The initial impression was a malignant ovarian new growth for which she underwent exploratory laparotomy. Intraoperatively, the ovaries have been converted to a large endometriotic cyst. The right ovarian cyst was adherent to the sigmoid colon and a fistulous tract was appreciated between the two structures. The patient underwent a total hysterectomy with bilateral salpingo-oophorectomy en bloc sigmoidectomy. Her postoperative course was unremarkable and she was discharged on the fifth postoperative day.