No abstract available.
Colectomy*

Colectomy ; Colorectal Neoplasms ; surgery ; Humans

BACKGROUND/AIMS: A number of studies have reported wide variability in the colonoscope insertion time among patients who had prior abdominal surgery. The aim of this study was to investigate the effect of abdominal surgery on colonoscope insertion time. METHODS: The subjects were 192 patients with prior abdominal surgery, among 3,600 patients who underwent a colonoscopy at Samsung Changwon Hospital from May 2008 to May 2010. We collected the following data: insertion time, age, gender, height, weight, BMI, waist circumference, method of abdominal surgery, and the degree of bowel cleanliness. Previous abdominal operations were divided into colectomy, non-colectomy abdominal surgery, pelvic surgery, and laparoscopic surgery groups. RESULTS: The average colonoscope insertion time in patients with prior abdominal surgery (7.73+/-5.95 min) was longer than that of the non-surgery group (6.4+/-3.88 min). Patients in the colectomy groups were older and had a shorter insertion time (5.11+/-3.32 min) than patients in the other groups. CONCLUSIONS: Insertion of a colonoscope in patients with previous abdominal surgery was more difficult than that in the control group, except the colectomy group.
Colectomy ; Colonoscopes ; Colonoscopy ; Humans ; Laparoscopy ; Waist Circumference

Management of chronic constipation with refractory symptoms can be challenging. Although new drugs and behavioral treatments have improved outcome, when they fail, there is little guidance on what to do next. At this juncture, typically most doctors may refer for surgical intervention although total colectomy is associated with morbidity including complications such as recurrent bacterial overgrowth. Recently, colonic manometry with sensory/tone/compliance assessment with a barostat study has been shown to be useful. Technical challenges aside, adequate preparation, and appropriate equipment and knowledge of colonic physiology are keys for a successful procedure. The test itself appears to be safe with little complications. Currently, colonic manometry is usually performed with a 6-8 solid state or water-perfused sensor probe, although high-resolution fiber-optic colonic manometry with better spatiotemporal resolutions may become available in the near future. For a test that has evolved over 3 decades, normal physiology and abnormal findings for common phenotypes of chronic constipation, especially slow transit constipation, have been well characterized only recently largely through the advent of prolonged 24-hour ambulatory colonic manometry studies. Even though the test has been largely restricted to specialized laboratories at the moment, emerging new technologies and indications may facilitate its wider use in the near future.
Colectomy ; Colon* ; Constipation* ; Manometry* ; Phenotype ; Physiology

PURPOSE: The results of a subtotal colectomy in colonic inertia, even those reported in the most recent literature, vary dramatically. The purpose of this study was to assess the effect of a colonic transit study on the results of a subtotal colectomy in colonic inertia. METHODS: Between 1992 and 1997, 30 patients underwent a subtotal colectomy with ileorectal anastomosis due to colonic inertia. Twenty-one of them underwent a colonic transit study only one time preoperatively, and 9 patients underwent such a study two times. The success rate was calculated using traditional definition with two sets of criteria. We modi fied the criteria of success by including new symptoms, such as abdominal, pelvic, or rectal pain, difficult evacuation, and loose stool or diarrhea. The success rate was recalculated using our more stringent cri teria, and compared between group 1 and group 2. RESULTS: By the traditional definition, the functional success rate was 100% for patients undergoing a colonic transit study two times preoperatively and 90% for patients undergoing only one study (p=0.34). By our more stringent criteria, the success rate was 100% for patients undergoing studies two times and 62% for those undergoing only one study (p=0.03). CONCLUSIONS: The success rate of a colectomy for colonic inertia was significantly higher for patients who underwent a repeat transit study than for those who underwent a single study. Patients who have two or more transit studies to confirm the diagnosis of inertia have a significantly higher probability of postoperative improvement of both bowel frequency and associated symptoms, such as pain and difficult evacuation. The mechanism for this discriminatory effect of repeated colonic transit studies requires elucidation by further study.
Colectomy* ; Colon* ; Constipation* ; Diagnosis ; Diarrhea ; Humans

Chronic constipation has been successfully treated with specific medications and bio-feedback therapy. Surgical manipulation for this condition can be an option when non-surgical interventions fail. We report here on a patient who was diagnosed as having intractable chronic constipation with hypoganglionosis. The patient was a 60 year-old male with the history of seizure and diabetes. This patient did not gain any clinical benefits from non-surgical regimens. Therefore, we performed a laparoscopically assisted total colectomy with J-pouch ileorectal anastomosis on this patient. The patient recovered from the surgery without complications and he had normal bowel functions. The postoperative anatomical pathology revealed a hypogaglionosis. In conclusion, a laparoscopically assisted total colectomy for a patient with intractable chronic constipation with hypoganglionosis is a good option and it may be a curative method.
Colectomy ; Colonic Pouches ; Constipation ; Humans ; Male ; Seizures

No abstract available.
Adenomatous Polyposis Coli* ; Colectomy* ; Humans ; Polyps*

No abstract available.
Colectomy* ; Colon* ; Colonic Neoplasms* ; Humans ; Stents*

PURPOSE: This study compared the perioperative clinical outcomes of reduced-port laparoscopic surgery (RPLS) with those of conventional multiport laparoscopic surgery (MPLS) for patients with sigmoid colon cancer and investigated the safety and feasibility of RPLS performed by 1 surgeon and 1 camera operator. METHODS: From the beginning of 2010 until the end of 2014, 605 patients underwent a colectomy for sigmoid colon cancer. We compared the characteristics, postoperative outcomes, and pathologic results for the patients who underwent RPLS and for the patients who underwent MPLS. We also compared the clinical outcomes of single-incision laparoscopic surgery (SILS) and 3-port laparoscopic surgery. RESULTS: Of the 115 patients in the RPLS group, 59 underwent SILS and 56 underwent 3-port laparoscopic surgery. The MPLS group included 490 patients. The RPLS group had shorter operating time (137.4 ± 43.2 minutes vs. 155.5 ± 47.9 minutes, P < 0.001) and shorter incision length (5.3 ± 2.2 cm vs. 7.8 ± 1.2 cm, P < 0.001) than the MPLS group. In analyses of SILS and 3-port laparoscopic surgery, the SILS group showed younger age, longer operating time, and shorter incision length than the 3-port surgery group and exhibited a more advanced T stage, more lymphatic invasion, and larger tumor size. CONCLUSION: RPLS performed by 1 surgeon and 1 camera operator appears to be a feasible and safe surgical option for the treatment of patients with sigmoid colon cancer, showing comparable clinical outcomes with shorter operation time and shorter incision length than MPLS. SILS can be applied to patients with favorable tumor characteristics.
Colectomy ; Colon, Sigmoid* ; Humans ; Laparoscopy* ; Sigmoid Neoplasms*

Circumferential resection margin(CRM) is the closest distance from the deepest of tumor invasion to the surgical margin of mesentery. It has been well known that CRM has significant impact on the prognosis and treatment of rectal cancer. However, the significance of CRM of colon cancer is just brought to the forefront recently. Current evidence showed positive rate of CRM is 10%, and the patients with positive CRM have worse survival. The factors influencing CRM include tumor stage, differentiation, vascular cancer embolus, etc. Standard surgical procedure can lower the positive rate of colon CRM, and adjuvant therapy applied to the patients with positive colon CRM can improve the survival of colon cancer patients. CRM may become a new factor guiding the treatment in colon cancer patients.
Colectomy ; methods ; Colonic Neoplasms ; surgery ; Humans ; Prognosis