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Swapnil Patel,Sriniket Raghavan,Amar Prem,Mayank Tripathi,Saumya Chopra,Durgatosh Pandey 대한종양외과학회 2021 대한임상종양학회 학술대회지 Vol.2021 No.6
Background/Aims Laparoscopic approach for total colectomy is acceptable ontologically if executed with a complete mesocolic excision and central vascular ligation to ensure radical D3 lymphadenectomy. Methods This is an illustrative video vignette showing a step by step approach to total colectomy with complete mesocolic excision with central vascular ligation. Our patient was a 45yr gentleman with adenocarcinoma of the transverse colon extending to splenic flexure and descending colon with synchronous polyps in right colon on colonoscopy. Staging computed tomography scan did not show any distant metastases. Results Total colectomy was done using laparoscopic approach with a complete mesocolic excision. Stapled ileo-rectal anastomosis was performed. Blood loss was 200mL and intra-operative period was uneventful. Post-operative period was uneventful and patient was discharged on day 6. Final histopathology revealed a moderately differentiated adenocarcinoma of transverse colon and left colon (pT3N1, 0/56 nodes) with dysplastic polyps in right colon. Patient was referred to Medical Oncology for adjuvant chemotherapy. Conclusions This video vignette highlights step by step conduct of a technically challenging procedure using laparoscopy while ensuring oncological adequacy.