Our Summary

This research paper discusses a surgery performed on a 73-year-old man who, after previously having bladder cancer, was diagnosed with a type 2 lesion in the sigmoid colon. The sigmoid colon is part of the large intestine, and a type 2 lesion is a type of abnormal tissue growth.

The patient underwent a laparoscopic sigmoidectomy, which is a minimally invasive surgery to remove part of the sigmoid colon. The surgery was carefully performed to avoid damaging the ureter (the tube that carries urine from the kidney to the bladder) and ileal conduit (a small pouch to hold urine after the bladder has been removed).

The surgery was successful, and the patient was discharged on the seventh day after his surgery, having made a good recovery. The research paper concludes that this case proves that laparoscopic surgery can be successfully and safely performed on patients with extensive adhesions (bands of scar tissue that can form between abdominal tissues and organs following surgery) from previous surgeries.

FAQs

  1. What is a laparoscopic sigmoidectomy?
  2. Can laparoscopic surgery for sigmoid colon cancer be performed on patients with a history of open surgeries and extensive adhesions?
  3. What precautions were taken during the laparoscopic sigmoidectomy to avoid damaging the ureter or ileal conduit?

Doctor’s Tip

A helpful tip a doctor might tell a patient about sigmoidectomy is to follow post-operative instructions carefully, including taking prescribed medications, maintaining a healthy diet, and attending follow-up appointments. It is also important to listen to your body and avoid strenuous activities until cleared by your doctor. Additionally, be sure to communicate any concerns or changes in symptoms to your healthcare provider promptly.

Suitable For

Patients who are typically recommended sigmoidectomy include those with sigmoid colon cancer, particularly those with advanced stage disease (such as cT3N0M0, cStage Ⅱa in the case described above). Additionally, patients who have a history of open surgeries, such as open total cystectomy for bladder cancer, may also be candidates for laparoscopic sigmoidectomy. This approach can be beneficial in patients with extensive adhesions from previous open surgeries, as it allows for a magnified view and precise surgical maneuvers that may be more challenging with traditional open surgery. Ultimately, the decision to recommend sigmoidectomy will depend on the individual patient’s specific condition and overall health status.

Timeline

  • Patient undergoes open total cystectomy for bladder cancer
  • Patient undergoes lower gastrointestinal endoscopy for positive fecal occult blood
  • Type 2 lesion in sigmoid colon is diagnosed
  • Preoperative diagnosis of cT3N0M0, cStage Ⅱa
  • Laparoscopic sigmoidectomy (D3 dissection) performed
  • Surgery prioritizes mobilizing near the root of the IMA to avoid damage to ureter or ileal conduit
  • Patient discharged on 7th postoperative day after uneventful recovery
  • Feasibility and safety of laparoscopic surgery demonstrated in patient with extensive adhesions from previous open surgeries

What to Ask Your Doctor

  1. What are the risks and benefits of having a sigmoidectomy for sigmoid colon cancer?
  2. How will the surgery be performed (laparoscopic vs open) and what can I expect during the recovery process?
  3. Will the surgery affect my previous open total cystectomy for bladder cancer in any way?
  4. Are there any alternative treatment options for my condition?
  5. What is the expected prognosis after the sigmoidectomy?
  6. Will I need any additional treatments such as chemotherapy or radiation therapy after the surgery?
  7. How often will I need follow-up appointments and monitoring after the surgery?
  8. Are there any dietary or lifestyle changes I should make before or after the surgery to aid in my recovery?
  9. How long will it take for me to fully recover and return to normal activities after the sigmoidectomy?
  10. Are there any potential complications I should be aware of after the surgery?

Reference

Authors: Takashima J, Kobayashi H, Koizumi A, Shigehara F, Yamasaki K, Sugimoto H, Fujimoto D, Kuroda H, Miura F. Journal: Gan To Kagaku Ryoho. 2025 Jan;52(1):76-78. PMID: 39957231