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.
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