The vena renalis has been clipped and is ready to be cut.

The vena renalis has been clipped and is ready to be cut.

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Synchronous renal cell carcinoma in patients with colorectal carcinoma is reported in various percentages ranging from 0.03 up to 4.85% (Halak et al. (2000), Capra et al. (2003)). When surgical treatment is indicated usually two separate operations are planned for resection. In open surgery, in such cases simultaneous resection is recommended if po...

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... Currently, videolaparoscopic treatment is possible and considered the initial choice, although it requires a lot of experience, and in most cases, two teams for each procedure [14]. Another associated difficulty is the control of operative time, which can be over-understood [15]. Robotic surgery has proven to be a viable option when available [16]. ...
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Introduction Even though colorectal cancer is one of the most frequent in the world, its simultaneous presence with other neoplasms, such as renal, is still rare in incidence. This article aims to report and expose a literature review of the synchrony of colorectal cancer and renal carcinoma. Presentation of case A 57-year-old female patient complaining of diffuse abdominal pain that worsened with food and improved with evacuation, especially in the periumbilical region and right iliac fossa, from moderate to strong intensity, starting 1 year ago, worsening in the last 3 months. An abdominal CT scan was performed, showing a lesion in the right kidney and a narrowing of the ascending colon lumen. Due to the possibility of cure, we opted for right colectomy and right nephrectomy at the same surgery. Discussion Synchronous tumors are neoplasms in which the diagnostic interval is up to 6 months, and must be differentiated from metachronic neoplasms and even metastases between tumors. The incidence of synchronous colorectal and renal cancer is rare but appears to be divergent. Conclusion The presence of synchronous tumors can be evidenced in imaging tests, such as CT scan, but appropriate diagnostic tests for each neoplasm, such as colonoscopy, should not be ruled out. The treatment of choice must be surgery, when possible, with the options of conventional access, videolaparoscopic and robotic surgery.
... By planning and preparing everything in advance and having in mind our experience in laparoscopic surgery, we were able to perform this difficult synchronous resection in a single stage. According to the literatures, simultaneous laparoscopic resection in synchronous tumors is a reliable and safe approach without further complications and is associated with a reduction in postoperative pain and hospital stay, quick recovery and normal daily activities, good cosmetic effect, and a relatively short surgical duration [7,8,10,[12][13][14]. The benefits of this technique for our patient were early movement, feeding, and discharge after laparoscopic resection, as well as earlier initiation of adjuvant treatment. ...
... According to Simon, the open surgical approach is reliable and could prevent second surgical intervention, but it also has disadvantages such as large surgical incision for better visibility on various surgical fields and a higher rate of postoperative complications [7]. The postoperative outcomes are good concerning the complications and oncological follow-up as no metastases are observed [8]. Studies of laparoscopic approach in patients with colorectal carcinoma or renal cell carcinoma showed that longterm outcomes are very similar and comparable [9]. ...
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Introduction: Multiple synchronous neoplasms were first described in a study by Billroth in 1889. Since then, many researches have been conducted in this field till 1932 when Warren and Gates published their criteria for the diagnosis of two synchronous tumors. Synchronous colorectal and renal blastomas are rare. The number of case reports published so far is relatively small. Case presentation: We report a case of a 63-years old male patient who was admitted to our clinic with symptomatic, histologically confirmed rectal adenocarcinoma located near the anorectal line. Contrast-enhanced CT showed evidence of synchronous lesion in the left kidney area. Laparoscopic left nephrectomy was performed, followed by abdominoperineal resection of the rectum with total mesorectal excision and para-aortic lymph dissection. Both resectates were extracted through the perineal access with no need for additional abdominal incision. No similar case was found in our literature review without using abdominal incision. Conclusion: The simultaneous multi-visceral laparoscopic resection of synchronous neoplasms is a reliable and safe method in certain patients. When performed by an experienced surgical team, the oncological outcomes are comparable to those achieved; using a conventional approach. A specific advantage is that this is a one-stage surgery that provides quick recovery with lower risk of postoperative complications.
... Combined laparoscopic resection of synchronous intraabdominal tumors is a reliable and safe approach with no evidence of additional postoperative complications. Reduced pain, shorter hospital stay, early return to normal life, much better cosmetic effects, operative time comparable to the open approach, comparable oncological results, and no port-associated implantation metastases have been observed (16,18,19).The laparoscopic resections we performed support completely this data, except for the operation time, which appeared to be shorter with open interventions. One drawback of mini-invasive synchronous kidney and colorectal resection may be the need of two separate teams -colorectal and urological, both with experience in laparoscopic surgery. ...
... It is very important to determine the position of working ports prior to synchronous laparoscopic resection (17,19). In contralateral tumors, a change in the position of both the trocars and the patient may be required (7). ...
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ABSTRACT Background: Synchronous tumors are rare clinical entity. In most cases, they are found accidentally in the process of primary tumor staging. The detection rate of synchronous blastomas has increased over the past decades due to the advance and more frequent use of imaging modalities. Only a few cases of colorectal carcinoma (CRC) and concurrent incidental renal tumors have been reported in recent years, with their incidence rates varying as reported by different authors (0.043-4.85%). Methods: We performed retrospective analysis of our database for patients, admitted for elective colonic resection for CRC, who had adequate preoperative staging (abdominal CT or MRI), and presented with simultaneous renal tumors. Between 2009 and 2018 we identified 1472 cases of CRC. Of them 1345 underwent radical surgery, preoperative imaging was available for 1117 patients (83%), among whom 4 were diagnosed with synchronous neoplasms (0.35%). Results: The average age in our group was 52.5 years (43-63), with male/female ratio of 1:1. CRC was the initial diagnosis, and renal tumors were accidentally detected by CT scan in the staging process. Three of the patients had combination of rectal and left kidney cancer, and one had ascending colon cancer and right kidney cancer. All 4 patients underwent simultaneous removal of both tumors: two patients underwent open and two laparoscopic procedures. Conclusions: Although rare, synchronous colorectal and renal tumors may be encountered, mainly thanks to preoperative diagnostic imaging. Performing simultaneous resection is safe and is not associated with increased complication rate. The laparoscopic approach is a viable option, when performed by an experienced team. Key words: synchronous colorectal and renal tumors; simultaneous resection; laparoscopic colorectal resection; laparoscopic nephrectomy; synchronous tumors
... We searched the literature for simultaneous laparoscopic resection of concurrent CRC and renal carcinoma and found 11 articles. [6][7][8][9][10][11][12][13][14][15][16] Results are summarized in Table 1. The median of operative time was 300-420 min and median of blood loss was 60-100 ml. 4 of the 9 was combined left-side and right-side laparoscopic procedure. ...
... Par ordre de fréquence, la prostate, la vessie, le poumon, le sein et le colon étaient les localisations les plus rapportées [12]. La plupart des carcinomes coliques et rénaux étaient métachrones [7,[12][13][14][15][16][17]. Dans ce cadre, le carcinome rénal était habituellement de découverte fortuite, lors du bilan d'extension radiologique, comme c'était le cas chez notre patiente, ou au cours du suivi post-thérapeutique [13][14][15][16][17]. ...
... La plupart des carcinomes coliques et rénaux étaient métachrones [7,[12][13][14][15][16][17]. Dans ce cadre, le carcinome rénal était habituellement de découverte fortuite, lors du bilan d'extension radiologique, comme c'était le cas chez notre patiente, ou au cours du suivi post-thérapeutique [13][14][15][16][17]. ...
... Parmi les études ayant porté sur les associations CCR et cancers du rein, neuf seulement se sont intéressées aux types histologiques propres à cette entité.Ces séries avaient porté sur un total de 15 patients [13][14][15][16][18][19][20][21][22] (Tableau 2). Dans ces séries, les CCR étaient tous des adénocarcinomes, de siège souvent rectal (9 cas) et colique droit (3 cas). ...
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La découverte de tumeurs primitives synchrones à un cancer colorectal a fait l’objet de plusieurs publications. Cette association peut survenir de manière sporadique ou rentrer dans le cadre de syndromes cliniques bien définis tel que le syndrome de Lynch. L’association synchrone d’un cancer colorectal (CCR) et d’un carcinome à cellules rénales est rare. Elle est encore plus rare lorsque le carcinome à cellules rénales est de sous-type papillaire avec seulement 2 cas rapportés dans la littérature. L’association CCR et rénaux ne semble pas être liée à une anomalie des protéines du système MMR (MisMatch Repair) et n’intègre à ce jour aucun syndrome clinique. Nous rapportons le cas d’une femme âgée de 69 ans qui a simultanément présenté un adénocarcinome colique et un carcinome papillaire du rein de type 1, de découverte fortuite au cours du bilan d’extension du CCR. Nous discuterons la pathogénie ainsi que le pronostic de cette entité rarement décrite.
... A few cases of simultaneous laparoscopic surgery have been reported for synchronous colorectal and renal disease on the same side of the abdomen. 5-7 Veenstra et al. 6 and O'Sullivan et al. 7 reported feasible simultaneous laparoscopic surgery on the contralateral side of the abdomen. The present report describes two cases of ipsilateral and contralateral abdominal procedures. ...
... One additional 10 mm and one 5 mm trocar are then inserted under laparoscopic vision in the epigastric and midclavi cular positions. 9 The left kidney can also be approached with the camera port placed just to the left of the umbilicus. The left hand 12 mm port placed along the lateral border of the rectus abdominis muscle lateral to the umbilicus. ...
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Background: Reports have suggested increased use of laparoscopy in the treatment of urological diseases and equally wrong port positions as the commonest cause of struggling during surgeries and increased in complications and operative time. Aim: We aimed to find out the ideal positions for laparoscopic ports to be placed during urological procedures. Methods: We performed different laparoscopic tasks in both the upper and lower urinary tract regions, at different ports position making different manipulation angles and operative time recorded. The procedures were performed on both dry and wet laboratory and on human during laparoscopic donor nephrectomies. Results: The average operative time of those ports whose position approximate to manipulation angle of 60º was shorter and more comfortable to the surgeons. Conclusion: There is no ideal positions for port placement in urological procedures based on anatomical landmarks, but rather any position that approximate its manipulation angle to as close to 60º as possible. © 2014, Jaypee Brothers Medical Publishers (P) Ltd. All rights reserved.
... Laparoscopic surgery represents a therapeutic option for these patients. Indeed very few reports available in the literature have already described a simultaneous laparoscopic nefrectomy and hemicolectomy for both ipsilateral and contralateral tumours (4)(5)(6)(7)(8). ...
... Classically two-stage surgery is planned for resection of synchronous cancers. The literature already reported some cases of successfully one-stage laparoscopic surgery for simultaneous tumours (4)(5)(6)(7)(8). We reported that a multiple laparoscopic resection in the same session is feasible, safe, and probably the best choice for the patient. ...
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We describe a case of a patient with synchronous bilateral colorectal tumours and renal carcinoma who underwent one-stage laparoscopic surgery procedure with right transperitoneal nefrectomy, right hemicolectomy and sigmoidectomy. One-stage laparoscopic procedure can be used safely and successfully for a patient with multiple primary tumours.
Article
Background: Indications for combined colon surgery together with other procedures include oncologic multivisceral resections and abdominal trauma. It is unclear if combining minimally invasive (MI) colon surgery with unrelated other procedures increases the risk for complications. Patients and Methods: The surgical database from two institutions during a 10-year period was queried for combined colon surgeries together with other interventions. All open cases, combined cases performed for one pathology and MI colectomies together with a minor procedure, were excluded. Results: Median age of the 6 men and 7 women was 64.4 (range 42.7-75.4) years. Colon surgeries included right (5), sigmoid (4) transverse (1) colectomies, rectum resection (1), rectopexy (1), and colostomy reversal (1) with indications of colorectal cancer (5), diverticulitis (3), benign ileocecal mass (1), colonic volvulus (3) and rectal prolapse (1). Second procedures included two splenectomies (sarcoidosis, ITP), paraesophageal hernia repairs (4), right diaphragmatic repairs [eventration (2) and Morgagni type hernia]; cholecystectomies (2), appendectomy (acute appendicitis), duodenal wedge resection (carcinoid), reversal of a gastric bypass (Roux limb stricture) one each. Cases were done laparoscopically (7) and robotic assisted (6). In most cases only 4 trocars were used. Median OR time was 4.3 (range 2.5 to 6.6) hours. No anastomotic breakdown was observed. Conclusions: Combining MI colectomy and other major abdominal surgeries can be safely done and in this series did not increase morbidity or mortality but avoids a second operation. Patient selection seems important and port placement may need to be altered to achieve good exposure for both procedures.
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posterior, y esternotomía cuando su ubicació n es anterior. Algunos autores 1 especifican que la esternotomía debe ser utilizada en los casos en los que se ha realizado previamente una tiroidectomía cervical, o bien si se trata de un carcinoma invasivo, o un bocio ectó pico. Si es posible, hay quien prefiere llevar a cabo un enfoque cervical en casos seleccionados 2,3. Sin embargo, el futuro va en la direcció n de los procedimientos mínimamente invasivos, por lo que la resecció n de bocios ectó picos mediastínicos por cirugía toracoscó pica, y robó tica mediante da Vinci tambié n ha sido descrita 4,5. Desde 2005 6,7 , se han publicado varios artículos sobre el abordaje uniportal en el tó rax, hasta llegar a realizar, recientemente, resecciones pulmonares mayores por una ú nica incisió n 8,9. Pero no hemos podido encontrar el uso de un solo puerto en las resecciones por VATS de esta enfermedad. En nuestro caso, el cuarto espacio intercostal dio una mejor exposició n y acceso a la regió n apical y la línea axilar anterior permitió optimizar la visualizació n del paramediastino superoposterior. El toracoscopio de 308 no fue necesario: se utilizó un toracoscopio de 08 para una resecció n má s intuitiva y fá cil. Hemos preferido un procedimiento uniportal, ya que una de las ventajas sobre la cirugía multipuerto es que solo está involucrado un espacio intercostal, permitiendo menor dolor postoperatorio 10. Y, en la misma línea de reducció n del dolor, preferimos utilizar un solo tubo de 20 Fr para disminuir el trauma en los tejidos blandos con respecto a otros tubos má s grandes. La estancia hospitalaria fue muy corta y no hubo complicaciones. Por otro lado, el uso de plá sticos para proteger la puerta es bien conocido, existen empresas con versiones caras y econó micas del mismo producto. La forma má s bá sica y econó mica es la esterilizació n de «bolsas de plá stico para sá ndwiches». Pero, nuestra idea de recortar el mango de luz y usarlo para proteger el puerto es un recurso de acceso fá cil, puesto que está en el quiró fano, que nos proporcionó una ó ptica limpia y maximizó la eficiencia. En conclusió n, la resecció n toracoscó pica por ú nico puerto para bocios ectó picos mediastínicos es otra opció n a valorar a la hora de definir un abordaje, puesto que, tal y como hemos descrito, es posible y nos permitió una estancia hospitalaria corta, sin impedir el uso de recursos a su travé s.