A laparoscopic high anterior resection for sigmoid cancer with extraction through incarcerated left inguinal hernia repaired with Permacol mesh

Carr, William; O'Dair, Graham N

doi:10.1136/bcr.02.2012.5788

Cited by 9 publications

(6 citation statements)

References 11 publications

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“…The laparoscopic approach has only been described in four cases, all in an elective setting [ 3 , 7 , 9 , 10 ]. In most cases, inguinal hernia repair was performed during the same operation.…”

Section: Discussionmentioning

confidence: 99%

Incarcerated sigmoid large-cell neuroendocrine carcinoma in an inguinal hernia

Gerosa¹,

Incarbone

Fratta³

et al. 2021

Journal of Surgical Case Reports

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Large-cell neuroendocrine carcinomas (NECs) of the colon are extremely rare aggressive tumors. A 79-year-old man presented at our hospital for muco-hematic diarrhea, weight loss and incarcerated hernia in his left groin. Colonoscopy revealed sigmoid stenosis. Computed tomography confirmed an incarcerated hernia containing sigmoid mass and massive abdominal adenopathy. In absence of colonic obstruction, the patient underwent elective palliative sigmoid resection and colostomy by laparoscopic approach, and direct hernia repair through inguinal access. Histopathological examination revealed a large cells sigmoid NEC. We report the first case of large-cell neuroendocrine colon cancer incarcerated in an inguinal hernia. Due to the advanced stage, we have performed a palliative laparoscopic resection in order to reduce surgical trauma, confirm pre-operative results and minimize post-operative complications, and direct hernia repair through inguinal access.

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Section: Discussionmentioning

confidence: 99%

Incarcerated sigmoid large-cell neuroendocrine carcinoma in an inguinal hernia

Gerosa¹,

Incarbone

Fratta³

et al. 2021

Journal of Surgical Case Reports

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“…Rutine colonoscopy revealed a sigmoid cancer. Simultaneously sigmoid colon resection and hernioplasty were made by laparoscopy technique 3 . Beznicza et al present four patients with concomitant inguinal hernia and colon cancer.…”

Section: Discussionmentioning

confidence: 99%

“…Simultaneously sigmoid colon resection and hernioplasty were made by laparoscopy technique. 3 Beznicza et al present four patients with concomitant inguinal hernia and colon cancer. They conclude that in the cases of large hernias, especially those rapidly growing, colonoscopy should be a routine diagnostic procedure, applied to assess the colon and the possible detection of the tumor.…”

Section: Discussionmentioning

confidence: 99%

An irreducible left scrotal hernia containing a sigmoid colon tumor (adenocarcinoma) – Case report

Gnaś¹,

Bulsa²,

Czaja‐Bulsa

2014

International Journal of Surgery Case Reports

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INTRODUCTIONIn relation to all inguinal hernias, large irreducible scrotal hernias are quite rare, while such hernias containing colon tumors in the sac have so far been described in fewer than 30 cases.PRESENTATION OF CASEA 61-year-old patient was admitted for a planned surgery because of a large irreducible left-sided scrotal hernia. Intraoperatively, a large tumor of the sigmoid colon was found in the hernial sac. In a histopathological examination it was diagnosed as adenocarcinoma. A palliative operation was performed and he was referred to further systemic and palliative treatment (because of numerous coexisting liver metastases).DISCUSSIONUntil now, only about 30 cases of colon tumor in inguinal hernia sac have been reported.CONCLUSIONIt should be remembered that even the most obvious preoperative diagnosis may be verified intraoperatively.

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“…With adequate pre-operative work-up and favourable anatomical and tumour characteristics it may be possible to manage some cases with a laparoscopic approach. 6,7 Preoperative diagnosis of advanced disease allowed preoperative planning in our case described above, however, smaller cancers may conceivably be first detected intra-operatively. With adequate planning, we were able to perform an oncologically acceptable resection as well as definitive treatment of significant bilateral inguinal hernia through a single incision.…”

mentioning

confidence: 90%

Incarcerated inguinoscrotal hernia containing sigmoid colon cancer

Daly

Filgate

Muhlmann

2016

ANZ Journal of Surgery

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Incarcerated inguinoscrotal hernia containing sigmoid colon cancerAn 81-year-old man presented with a large left inguinoscrotal hernia, which had been present for at least 5 years, as well as a large right inguinal hernia. He reported recent weight loss, lethargy, fatigue and significant functional decline. He had no history of bleeding per rectum, malaena or significant change in bowel habit. Clinical examination revealed a soft reducible right inguinal hernia, and a large, firm irreducible left inguinoscrotal hernia. The overlying skin of the left hemiscrotum was erythematous.Investigations revealed a microcytic, hypochromic anaemia with haemoglobin 78 g/L. Serology was consistent with poor nutrition and a catabolic state, including serum albumin of 21 g/L. Serum tumour markers were raised, with CEA 16 mcg/L (normal range 0-4) and CA125 56 ku/L (0-35).Computed tomography imaging confirmed the presence of an indirect left inguinoscrotal hernia containing distal descending and proximal sigmoid colon (Fig. 1). The herniated bowel contained a complex, heterogeneous mass measuring approximately 10 cm in maximal diameter, suspicious for colon cancer. Three ill-defined, low-density lesions within the liver appeared consistent with hepatic metastases. Preoperative colonoscopy was not performed due to anticipated difficulty of accessing the incarcerated colon, and adequate diagnostic information being attained by clinical, radiological and biochemical means. Should the hernia have been reducible, then colonoscopy would have been attempted including biopsy for tissue diagnosis.The patient underwent a high anterior resection with en bloc resection of the left spermatic cord and testicle, followed by bilateral inguinal hernia repair. This was performed via a midline laparotomy with dissection of the left pre-peritoneal plane to access the inguinal canal. The neck of the hernia was incised to enable difficult reduction of its contents, and en bloc resection with the sigmoid colon and upper rectum was performed (Fig. 2). A high ligation of the inferior mesenteric artery was performed, and a standard stapled anastomosis was formed between the descending colon and the proximal rectum. The left testicle and spermatic cord were necessarily sacrificed due to dense adhesion to the hernia sac and tumour mass, and were included in order to achieve adequate oncological clearance. Posterior mesh repair of bilateral inguinal hernias was then performed, with the inguinal region accessed in the pre-peritoneal plane through the midline laparotomy wound.Tissue histopathology confirmed the diagnosis of a moderately differentiated adenocarcinoma measuring 11 cm in diameter, with surrounding abscess and extensive inflammation and fibrosis. Local invasion was beyond the muscularis propria but not through the serosal surface, and metastatic adenocarcinoma was present in one of 28 regional lymph nodes. The left testis showed significant atrophy.Incorporating surgical and radiological staging, the patient had AJCC Stage IVA colorectal cancer (T3N...

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A laparoscopic high anterior resection for sigmoid cancer with extraction through incarcerated left inguinal hernia repaired with Permacol mesh

Cited by 9 publications

References 11 publications

Incarcerated sigmoid large-cell neuroendocrine carcinoma in an inguinal hernia

Incarcerated sigmoid large-cell neuroendocrine carcinoma in an inguinal hernia

An irreducible left scrotal hernia containing a sigmoid colon tumor (adenocarcinoma) – Case report

Incarcerated inguinoscrotal hernia containing sigmoid colon cancer

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