Abstract
Background
The Deloyers procedure, which includes inversion of the right colon around the axis of the ileocolic vessels, can be used to achieve a well vascularized, tension-free colorectal anastomosis after extended left colectomy. The aim of this study is to report our technique and outcome in a series of ten consecutive patients who underwent right colonic transposition by laparoscopic approach.
Methods
Charts were retrospectively reviewed to analyze postoperative outcome and bowel function. A video was recorded to demonstrate the procedure.
Results
Conversion was required in one (10%) patient due to extensive adhesions. No intraoperative complications were recorded. Anastomotic leakage occurred in one (10%) case and was managed with peritoneal lavage and ileostomy. Six months after surgery, all patients reported a median number of 2.5 (range 2–3) bowel movements per day with solid stool consistency. Neither anastomotic stricture nor bowel ischemia was found at 1-year endoscopic follow-up.
Conclusion
Our experience shows that laparoscopic right colonic transposition is a safe and feasible procedure and provides good functional outcomes.
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References
You YN, Chua HK, Nelson H, Hassan I, Barnes SA, Harrington J (2008) Segmental vs. extended colectomy: measurable differences in morbidity, function, and quality of life. Dis Colon Rectum 51:1036–1043
Lim JF, Ho YH (2001) Total colectomy with ileorectal anastomosis leads to appreciable loss in quality of life irrespective of primary diagnosis. Tech Coloproctol 5:79–83
Shariff US, Kullar N, Dorudi S (2011) Right colonic transposition technique: when the left colon is unavailable for achieving a pelvic anastomosis. Dis Colon Rectum 54:360–362
Kontovounisios C, Baloyiannis Y, Kinross J, Tan E, Rasheed S, Tekkis P (2014) Modified right colon inversion technique as a salvage procedure for colorectal or coloanal anastomosis. Colorectal Dis 16:971–975
Hyman N, Manchester TL, Osler T, Burns B, Cataldo PA (2007) Anastomotic leaks after intestinal anastomosis: it’s later than you think. Ann Surg 245:254–258
Dumont F, Da Re C, Goéré D, Honoré C, Elias D (2013) Options and outcome for reconstruction after extended left hemicolectomy. Colorectal Dis 15:747–754
Manceau G, Karoui M, Breton S et al (2012) Right colon to rectal anastomosis (Deloyers procedure) as a salvage technique for low colorectal or coloanal anastomosis: post-operative and long-term outcomes. Dis Colon Rectum 55:363–368
Roncoroni L, Sarli L, Costi R, Violi V (2000) Caecal-rectal antiperistaltic anastomosis without torsion of the vascular pedicle. Ann Chir 125:871–873
Ryan J (2012) Right colonic transposition technique. Dis Colon Rectum 55:e364
Sakamoto Y, Tokunaga R, Miyamoto Y et al (2016) Retroileal colorectal anastomosis after extended left colectomy: application for laparoscopic surgery. Surg Today 46:1476–1478
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All procedures performed in this study were in accordance with the ethical standards of the institution.
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Informed consent was obtained from all individual participants included in the study.
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Sciuto, A., Grifasi, C., Pirozzi, F. et al. Laparoscopic Deloyers procedure for tension-free anastomosis after extended left colectomy: technique and results. Tech Coloproctol 20, 865–869 (2016). https://doi.org/10.1007/s10151-016-1562-z
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DOI: https://doi.org/10.1007/s10151-016-1562-z