Ischemic colitis following cardiac surgery is a rare but critical complication. We report two cases of ischemic colitis following cardiac surgery successfully treated with stenting of the stenotic celiac trunk. Case 1 was a 65-year-old man who developed perioperative myocardial infarction during off-pump coronary artery bypass grafting. He experienced abdominal pain and bloody stool on postoperative day 19. Severe ischemic changes in the sigmoid colon and descending colon were seen on colonoscopy, and CT scan revealed significant stenosis of the celiac trunk and occlusion of the inferior mesenteric artery and bilateral internal iliac arteries. Revascularization of the celiac trunk via stenting resulted in dramatic improvement in colonic ischemic changes. Case 2 was a 60-year-old woman who underwent a restoration procedure for a left ventricular aneurysm. She experienced gradual onset of postprandial pain beginning 9 days after surgery and massive bloody stool on postoperative day 33. Imaging revealed severe ischemic changes in the descending colon on colonoscopy and stenoses of the celiac trunk, superior mesenteric artery, inferior mesenteric artery, and bilateral common iliac arteries on CT angiogram. Stenting was performed to the celiac trunk on postoperative day 52. Her abdominal pain and bloody stool were completely resolved after treatment. Prior to the introduction of endovascular treatment of mesenteric ischemia in 1980, the standard treatment had been open surgical repair. Since then, endovascular repair has become widely accepted. In our experience, endovascular treatment of the mesenteric vessels may be an effective and less invasive approach to treating mesenteric ischemia in unstable patients after cardiac surgery.

Since the beginning of laparoscopic liver surgery, resection of the posterosuperior segments has been considered one of the most challenging procedure due to its difficult access. The main drawbacks of the laparoscopic approach to dome lesions are poor visualization, the difficulty of instrumentation and the greater complexity in the control of bleeding. In the evolution of minimally invasive techniques from hybrid techniques to the current purely laparoscopic approaches, the different authors have established gradually the currents indications and surgical techniques to operate these segments with a similar feasibility and safety than open approach. The standardization in the patient position, the use of intercostal trocars, the learning curve in laparoscopic liver surgery, the management of the hepatic blood flow and the refinement of the technique in the extrahepatic and intrahepatic Glissonean pedicle approaches, has allowed to leave behind the initial contraindications about the laparoscopic approach in these segments. In the present review of the literature, the accumulated experience of the different groups in minimally invasive liver surgery together with the technological advances in the different laparoscopic devices have facilitated the resection of tumors in segments 7 and 8 with similar and even better results than open surgery.