Laparoscopic Right Hemicolectomy and Primary Anastomosis for Tubulovillous Polyp with Preoperative Endoscopic Tattooing as A Preventive Treatment in High Risk Colorectal Cancer Patient Case Report and Review

Veronica Salais

doi:10.32474/oajom.2020.04.000181

Abstract

Highlights

It is well established that colorectal cancer (CRC) develops from a series of precursor epithelial polyps [1], which include conventional adenomas, incorporating tubular adenomas and villous/tubulovillous adenomas (VA/TVA) and serrated polyps, incorporating hyperplastic polyps (HP), sessile serrated adenomas (SSA) and traditional serrated adenomas (TSA)
A polyp with more than 75% villous features, i.e., long finger-like or leaf-like projections on the surface, is called a villous adenoma, while tubular adenomas are mainly comprised of tubular glands and have less than 25% villous
Performing pneumoperitoneum at 15mmHg, a diagnostic laparoscopy is started, the ileocecal valve is identified, an opening of the meso in the terminal ileum is performed at 10 cm from the valve, sectioning with a 60 mm endoGIA stapler, opening the right TOLD fascia, and subsequent opening of the right mesocolon with a 5 mm ligasure, with adequate identification of the right colic artery, the hepatic angle of the colon is released until the endoscopic tattoo is identified and the transverse colon is sectioned using an endoGIA stapler 60 mm 7 cm distal to the tattoo

Summary

Introduction

It is well established that colorectal cancer (CRC) develops from a series of precursor epithelial polyps [1], which include conventional adenomas, incorporating tubular adenomas and villous/tubulovillous adenomas (VA/TVA) and serrated polyps, incorporating hyperplastic polyps (HP), sessile serrated adenomas (SSA) and traditional serrated adenomas (TSA). Individuals with a family history of polyps, colorectal cancer, and intestinal polyposis carry a higher risk of developing colon polyps [3]. Depending on the pattern of growth, these tumors can be villous, tubular, or tubulovillous. A colonoscopy was performed with evidence of a granular scattered lateral growth lesion in the ascending colon, which cannot be resected by mucosectomy, which is why an endoscopic biopsy and tattoo was performed. The result of histopathology with tubulovillous polyp without evidence of dysplasia

Methods

Results

Conclusion