The da Vinci SP Surgical System (dVSP; Intuitive Surgical, Sunnyvale, CA, USA) was introduced to perform pure single-incision surgery in 2018. This new surgical platform demonstrated favorable performance compared with the positive aspect of single-incision laparoscopic surgery and robot surgery. To date, its use has mainly been in urological and gynecological procedures. We report a case of successful robotic single-incision right hemicolectomy for cecal cancer with the dVSP.
Cecal Neoplasms ; Laparoscopy

Pseudomyxoma peritonei is a rare disorder chracterized by abdominal distension resulting from the accumulation of a mucinous, gelatinous, translucent material which arises from rupture of pre-existing mucinous cystadenomas and cystadenocarcinomas of the ovary and mucocele of the appendix. We report 11 cases of pseudomyxoma peritonei which were diagnosed by surgical and pathological findings. The results were as follows. 1) The mean age of 11 cases was 51 years and 5 cases were male and 6 cases were female and male to female ratio was 1 to 1.2. 2) Clinical manifestations in 11 cases were abdominal distension in 5 cases (45.5%), palpable mass in 4 cases(36.6%), abdominal pain in 4 cases(36.6%), nausea in 3 cases(27.3%), weight loss in 3 cases(27.3%), diarrhea in 2 cases(18.2%), constipation in 1 case(9.0%), anal bleeding in 1 case(9.0%) and defecation difficulty in 1 case(9.0%). The duration of symptoms was 2 days to 1 year. 3) The primary sites of pseudomyxoma peritonei were ovarian cancer in 3 cases(27.2%), appendiceal cancer in 2 cases(18.2%), gastric cancer in 2 cases(18.2%), rectal cancer in 1 case(9.1%), cecal cancer in 1 case(9.1%) and unknown origin in 2 cases(18.2%). 4) Following surgical interventions were performed; right hemicolectomy in 2 cases, palliative gastrojejunostomy in 2 cases, oophorectomy in 1 case, omentectomy in 1 case and right hemicolectomy with gastrojejunostomy in 1 case. 5) The adjunctive anti-cancer chemotherapy was done in 4 cases(36.4%) by combination of actinomycin D, adriamycin, CCNU, cisplatin, cytoxan and fluorouracil, And chemotherapy only was done in 2 cases and hyperthermia was done in 1 case.
Abdominal Pain ; Appendiceal Neoplasms ; Appendix ; Cecal Neoplasms ; Cisplatin ; Constipation ; Cyclophosphamide ; Cystadenocarcinoma ; Cystadenoma, Mucinous ; Dactinomycin ; Defecation ; Diarrhea ; Doxorubicin ; Drug Therapy ; Female ; Fever ; Fluorouracil ; Gastric Bypass ; Gelatin ; Hemorrhage ; Humans ; Lomustine ; Male ; Mucins ; Mucocele ; Nausea ; Ovarian Neoplasms ; Ovariectomy ; Ovary ; Pseudomyxoma Peritonei* ; Rectal Neoplasms ; Rupture ; Stomach Neoplasms ; Weight Loss

Extramedullary plasmacytoma is a rare disease that is histopathologically defined as a solitary tumor composed of a monoclonal proliferation of cells with plasmacytic differentiation in an extramedullary site. Most of these tumors occur in the submucosa of the upper aerodigestive tract, and they rarely occur in the small bowel mesentery. We report here on a case of extramedullary plasmacytoma of the small bowel mesentery that was in association with a cecal cancer. Abdominal ultrasound and CT revealed a lobulated soft tissue mass with a cystic portion and peripheral calcification. In this case, the preoperative radiological diagnosis was difficult due to accompanying cecal cancer.
Cecal Neoplasms* ; Diagnosis ; Mesentery* ; Plasmacytoma* ; Rare Diseases ; Ultrasonography

With advancement of minimal invasive surgery, a simultaneous laparoscopy-assisted resection for colorectal cancer and metastasis has become feasible. Hence, we report three cases of simultaneous laparoscopic surgery for colorectal cancer with liver or lung metastasis. In the first case, laparoscopic right hemicolectomy and left lateral segmentectomy of liver was performed for ascending colon cancer and liver metastasis. In the second case, laparoscopic right hemicolectomy and wedge resection of right lower lung was performed for cecal cancer and lung metastasis. In the third case, laparoscopic right hemicolectomy and wedge resection of left lower lung was performed for ascending colon cancer and lung metastasis. In the first two cases, patients quickly returned to normal activity. In the third case, postoperative bleeding was observed, but spontaneously stopped. There was no postoperative mortality. Simultaneous laparoscopic surgery represents a feasible option for colorectal cancer with metastases on the other organs.
Cecal Neoplasms ; Colon, Ascending ; Colorectal Neoplasms* ; Hemorrhage ; Humans ; Laparoscopy ; Liver ; Lung ; Mastectomy, Segmental ; Mortality ; Neoplasm Metastasis*

Xanthogranulomatous inflammation is a chronic inflammatory condition characterized by aggregation of lipid-laden foamy macrophages (xanthoma cells). This disease entity is well- recognized in the kidney and gallbladder. However, involvement of the colon is extremely rare. Radiologically, xanthogranulomatous inflammation could be misinterpreted as a locally invasive cancerous lesion. Indeed, coexisting malignancy has been reported in xanthogranulomatous inflammation. In this case report, a woman complained of fever and right lower quadrant abdominal pain for a period of 5 days. A huge mass lesion with severe pericolic infiltration was found on abdominal CT scan. Right hemicolectomy was performed along with removal of the adjacent soft tissue and right ovary and fallopian tube. Pathology examination demonstrated xanthogranulomatous inflammation coexisting with cecal cancer (T3N0M0).
Abdominal Pain ; Cecal Neoplasms ; Colon ; Fallopian Tubes ; Female ; Fever ; Gallbladder ; Humans ; Inflammation ; Kidney ; Macrophages ; Ovary

The authors present a case of intussusception of the vermiform appendix with ade nocarcinoma. A 35-year-old male with lower abdominal pain and anemia was found to have an intussusception of the appendix associated with an adenocarcino-ma. The preoperative diagnosis was cecal cancer but we detected the iutussuscept-ion of the appendix with an adenocarcinoma during operation. Patient was managed with right hemicolectomy and has been followed up.
Abdominal Pain ; Adenocarcinoma* ; Adult ; Anemia ; Appendix* ; Cecal Neoplasms ; Diagnosis ; Humans ; Intussusception* ; Male

The incidence of intussusception in adults is quite low. A preoperative diagnosis was quite difficult due to the atypical clinical features, but the success rate of preoperative diagnosis of intussusception has improved with the advances in abdominal US and CT. However, the value of colonoscopy in making a preoperative diagnosis is unclear. The incidence of multiple primary cancer of the colon and rectum can vary widely. We report a case of intussusception in a patient who had synchronous cecal and sigmoid colonic cancer. A 71-year-old man was visited our hospital for diarrhea and general weakness. The abdominal US and CT revealed a mass lesion in the cecal area. Preoperative colonoscopy confirmed the lesion to be cecal cancer with a synchronous sigmoid colon cancer. In conclusion, the rarity of these synchronous cancers may result in a misdiagnosis. Therefore, a preoperative colonoscopy or postoperative colonoscopy might be useful.
Adult ; Aged ; Cecal Neoplasms ; Colon* ; Colon, Sigmoid* ; Colonic Neoplasms* ; Colonoscopy ; Diagnosis ; Diagnostic Errors ; Diarrhea ; Humans ; Incidence ; Intussusception* ; Rectum ; Sigmoid Neoplasms*

BACKGROUNDSingle incision laparoscopic colectomy has been performed in recent years, and has been shown to be feasible and safe. This study was to assess the feasibility of single incision laparoscopic right hemicolectomy and to compare the differences in different approaches.

METHODSThis retrospective study included eighteen patients with carcinoma of caecum and ascending colon, undergoing single incision laparoscopic right hemicolectomy. This study also compared single incision laparoscopic right hemicolectomy using different approaches: (1) single incision multiport, (2) single access port and (3) glove port.

RESULTSThere was no statistical difference in surgical outcomes. Concerning the surgeon's satisfaction toward three methods, overcrowding and durability were similar but the single incision multiport was associated with the highest gas-leak and the "glove" port was associated with poor durability. However, the method of single incision multiport has the lowest average cost of the special trocar or port in each operation. The operative time and blood loss of the operations in this study were comparable to previous publications.

CONCLUSIONThere was no significant difference between different approaches of single incision laparoscopic right hemicolectomy for colonic cancer in right side colon.

Aged ; Cecal Neoplasms ; surgery ; Colectomy ; methods ; Colonic Neoplasms ; surgery ; Female ; Humans ; Laparoscopy ; methods ; Male ; Middle Aged ; Retrospective Studies

BACKGROUND: This nationwide survey was undertaken to characterize the general pathological features of colorectal cancer in Korea, and especially to elucidate the geographical characteristics by means of their anatomical distribution. METHODS: We analysed 1,676 colorectal cancers (from 1,602 patients) surgically resected in 1998 at 15 institutions from nine geographical sites in Korea. RESULTS: The topographic incidence of colorectal cancer in seven out of the total nine geographical sites, was the highest in the rectum (32-54%); and those from Wonju and Cheongju were in the sigmoid colon (28% for both). The right colon cancer incidence was 42% in Wonju and 36% in Cheongju, while it was 17-22% in the other areas. The cecal cancer incidences in Wonju and in Taegu were 7% and 8%, respectively, but 0-4% in the other areas. As for histology, moderately differentiated adenocarcinoma was the most frequent (46-84%), except for in Wonju and Chonju, where the most predominant type was well differentiated (63% and 52%, respectively). CONCLUSION: The incidence of right colon cancer was higher in Wonju and Cheongju, than in the other geographical sites. The cecal predilection was prominent in Taegu and Wonju. The Elucidation of geographical differences in degree of differentiation for tubular adenocarcinoma seems to require further cumulative study with strict guidelines.
Adenocarcinoma ; Cecal Neoplasms ; Chungcheongbuk-do ; Colon, Sigmoid ; Colonic Neoplasms ; Colorectal Neoplasms* ; Daegu ; Gangwon-do ; Humans ; Incidence ; Jeollabuk-do ; Korea ; Pathology ; Rectum

Lymph node metastasis in early colon cancer is relatively low. Furthermore, skip metastasis beyond principle lymph node is very rare. This is a case of early cecal cancer with skip metastasis to portocaval and retropancreatic space, without regional lymph node metastasis. A 69-year-old female diagnosed as cecal adenocarcinoma. The imaging study revealed as early cecal cancer without enlargement of regional lymph node. However, there is enlargement of portocaval lymph node and high fluorodeoxyglucose (FDG) uptake in positron emission tomography scan image. Right hemicolectomy with extended lymph node dissection was done including retropancreatic, portocaval and hepatoduodenal ligament lymph node. Though whole abdominal cavity exploration was done, there was no evidence of other synchronous cancer. The final pathologic findings revealed the poorly differentiated adenocarcinoma with invasion of submucosal layer and focally superficial layer of muscularis propria. Two of total 27 lymph nodes were involved by metastastatic adenocarcinoma which were from portocaval and retropancreatic space. The detailed preoperative imaging study could find unexpected lymph node metastasis beyond range of routine lymph node dissection. Even though the preoperative clinical stage is relatively early, the detailed and sufficient evaluation for clinical and imaging findings is important not to ignore skip metastasis.
Abdominal Cavity ; Adenocarcinoma ; Aged ; Cecal Neoplasms ; Colonic Neoplasms ; Female ; Humans ; Ligaments ; Lymph Node Excision ; Lymph Nodes ; Lymphatic Metastasis ; Neoplasm Metastasis ; Positron-Emission Tomography