Laparoscopically-Assisted Repair of a Small Bowel Perforation                    Secondary to Multiple Metastases of Undifferentiated Pleomorphic                    Sarcoma

Morimoto, Manabu; Honjo, Soichiro; Sakamoto, Teruhisa; Yagyu, Takuki; Uchinaka, Ei; Hanaki, Takehiko; Watanabe, Junya; Matsunaga, Tomoyuki; Yamamoto, Manabu; Tokuyasu, Naruo; Fujiwara, Yoshiyuki

doi:10.33160/yam.2020.05.002

Cited by 4 publications

(6 citation statements)

References 16 publications

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“…There have been only a few cases of UPS in the gastrointestinal tract according to the diagnostic criteria after the WHO 2013 reclassi cation [4][5][6][7][8][9][10][11], and this is the second case with perforation of the gastrointestinal tract [4]. UPS lacks characteristic physical symptoms and imaging ndings.…”

Section: Discussionmentioning

confidence: 99%

Surgical Resection of Undifferentiated Pleomorphic Sarcoma (UPS) With Jejunal Perforation, A Suspected Case of Metastasis of Lung Cancer: A Case Report

Eto

Hoshino

Takiguchi

et al. 2021

Preprint

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Background: Undifferentiated pleomorphic sarcoma (UPS) in the gastrointestinal tract is rare. According to the diagnostic criteria after the World Health Organization 2013 reclassification, there has been only one case of UPS with perforation of the gastrointestinal tract.Case presentation: A 71-year-old man who was undergoing outpatient chemotherapy at the department of respiratory medicine of our hospital for lung cancer and brain metastasis, was admitted to our hospital with sudden high fever and abdominal pain. A computed tomography scan showed free air in the abdominal cavity with thickening of part of the jejunal wall. We suspected jejunal metastasis of lung cancer and performed emergency surgery for acute peritonitis due to gastrointestinal perforation in the same area. A Bormann type 2 tumor was found in the jejunum with perforation. The histopathological diagnosis was UPS. Ten months have passed since the surgery, and there has been no recurrence of UPS and no significant change in lung cancer.Conclusions: Primary UPS of the gastrointestinal tract is rare, and cases with perforation are extremely rare. Currently, ten months have passed since the surgery, and no recurrence has been observed. We encountered a case of UPS in which it was difficult to distinguish metastasis from lung cancer to the jejunum, and emergency surgery gave us the chance to confirm the definitive diagnosis and save the patient's life.

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Section: Discussionmentioning

confidence: 99%

Surgical Resection of Undifferentiated Pleomorphic Sarcoma (UPS) With Jejunal Perforation, A Suspected Case of Metastasis of Lung Cancer: A Case Report

Eto

Hoshino

Takiguchi

et al. 2021

Preprint

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“…As UPS/MFH progresses, it mainly spreads to the lungs (82%), lymph nodes (32%), liver (15%) and bones (11%), but rarely to the small intestine or colon. [2] There have been only a few cases of UPS in the gastrointestinal tract according to the diagnostic criteria after the WHO 2013 reclassification [4][5][6][7][8][9][10][11][12] and this is the second case with perforation of the gastrointestinal tract [4]. UPS lacks characteristic physical symptoms and imaging findings.…”

Section: Discussionmentioning

confidence: 99%

Surgical resection of undifferentiated pleomorphic sarcoma (UPS) with jejunal perforation, a suspected case of metastasis of lung cancer

Eto

Hoshino

Takiguchi

et al. 2021

Clin J Gastroenterol

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Undifferentiated pleomorphic sarcoma (UPS) in the gastrointestinal tract is rare. According to the diagnostic criteria after the World Health Organization 2013 reclassification, there has been only one case of UPS with perforation of the gastrointestinal tract. A 71-year-old man who was undergoing outpatient chemotherapy at the department of respiratory medicine of our hospital for lung cancer and brain metastasis, was admitted to our hospital with sudden high fever and abdominal pain. A computed tomography scan showed free air in the abdominal cavity with thickening of part of the jejunal wall. We suspected jejunal metastasis of lung cancer and performed emergency surgery for acute peritonitis due to gastrointestinal perforation in the same area. A Bormann type 2 tumour was found in the jejunum with perforation. The histopathological diagnosis was UPS. Ten months have passed since the surgery, and there has been no recurrence of UPS and no significant change in lung cancer. Primary UPS of the gastrointestinal tract is rare, and cases with perforation are extremely rare. Currently, ten months have passed since the surgery, and no recurrence has been observed. We encountered a case of UPS in which it was difficult to distinguish metastasis from lung cancer to the jejunum, and the emergency surgery gave us the chance to confirm the definitive diagnosis and save the patient's life.

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“…Diagnostic laparoscopy can be combined with manual manipulations through extended port access. This technique is called laparoscopy-assisted surgery, and presented in the literature mostly as case reports [39][40][41]. In our series, ML was used in patients with abdominal trauma as a therapeutic procedure (Fig.…”

Section: Table 3 Postoperative Complicationsmentioning

confidence: 99%

“…Much of the literature presenting surgical approach techniques tends to oppose different methods of mini-invasive and standard incisions [4,11,13]. However, ML incision in fact represents a technical step in performing the laparoscopy-assisted procedure, which is considered a standard operation in current abdominal surgery at present [40,43].…”

Section: Table 3 Postoperative Complicationsmentioning

confidence: 99%

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Mini-laparotomy in emergency general surgery in a second-level hospital in Zambia: a prospective cohort study

Karachentsev

Kadochi

2023

Preprint

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Background Being an integral part of the Enhanced Recovery After Surgery methodology, the mini-invasive surgical technique is an important factor in attenuating surgical stress and minimising the risk of postoperative complications. Here we present our experience of utilising the mini-laparotomy (ML) approach in emergency surgery.Methods This prospective clinical study included adult patients operated on for acute abdominal conditions at a second-level hospital in Zambia. Thirty-four patients were explored through ML, and another 34 participants had a standard laparotomy (SL) incision. The size of ML ranged from 6 to 12 cm, with the median being 10.5 cm. ML was not attempted in abdominal malignancy, generalised peritonitis, and as an approach for the relaparotomy procedures. Length of hospital of stay (LOS) and morbidity/mortality were primary endpoints. Secondary outcomes of interest included operating time (OT) and post-operative pain control. Continuous variables were presented as mean with standard deviation or median with ranges; categorical data were given as proportions and percentages. Associations between data were estimated using the t-test and chi-square analysis, as appropriate. LOS was compared by log-rank test and presented graphically by Kaplan-Meier survival curves. A p-value < 0.05 was considered statistically significant.Results The most common procedures performed through ML were resection of the small bowel or colon, closure of hollow viscus perforation or rupture, and adhesiolysis. Employment of ML was associated with reduced LOS (p = 0.0002), shorter OT (p = 0.0003), and minimised need for opioid analgesia (p = 0.01); however, the difference in postoperative complications was not statistically significant (ML: 21% versus SL: 27%, p = 0.57), and mortality was similar (6% in each group).Conclusions As our data showed, ML is a feasible and safe technique that could be used in emergency visceral surgery and abdominal trauma in well-selected patients. Having comparable postoperative morbidity with the SL approach, it might lead to reduced pain and enhanced recovery after the procedure. We proposed an algorithm for the selection of exploration method in patients presented with acute abdominal conditions that could be of help to acute care surgeon operating in a resource-limited setting.

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Laparoscopically-Assisted Repair of a Small Bowel Perforation Secondary to Multiple Metastases of Undifferentiated Pleomorphic Sarcoma

Cited by 4 publications

References 16 publications

Surgical Resection of Undifferentiated Pleomorphic Sarcoma (UPS) With Jejunal Perforation, A Suspected Case of Metastasis of Lung Cancer: A Case Report

Surgical Resection of Undifferentiated Pleomorphic Sarcoma (UPS) With Jejunal Perforation, A Suspected Case of Metastasis of Lung Cancer: A Case Report

Surgical resection of undifferentiated pleomorphic sarcoma (UPS) with jejunal perforation, a suspected case of metastasis of lung cancer

Mini-laparotomy in emergency general surgery in a second-level hospital in Zambia: a prospective cohort study

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