Our Summary

This research paper talks about a rare medical case where a 77-year-old man suffered from a condition called Sigmoid volvulus (SV), a painful twisting of the colon, after undergoing surgery for colon cancer. This condition is typically caused by factors like age-related digestive issues, chronic constipation, and neurological diseases, but it’s rarely seen after colon cancer surgery.

After his colon cancer surgery, the man developed a hernia (bulging of an organ or tissue) at the site of his surgery scar, which was also treated with a minimally invasive surgery using a mesh to repair the hernia. He didn’t have any complications from this surgery. However, over five years after his initial surgery, he again experienced abdominal pain and bloating. A scan revealed that he had SV — the remainder of his colon had twisted around the site of his previous surgery.

Although doctors were initially able to untwist his colon using a scope, the condition came back two months later. The man then had another minimally invasive surgery where the twisted part of his colon was removed and reconnected using a surgical stapler. This surgery went smoothly, with minimal blood loss and no complications.

Five years later, the man is doing well with no recurrence of SV or any other complications. This case suggests that doctors might need to consider preventive measures against SV in patients undergoing laparoscopic surgery for colon cancer, particularly if they have a long colon. It also highlights that repeat minimally invasive surgeries can be performed successfully with careful patient selection.

FAQs

  1. What is Sigmoid volvulus (SV) and what typically causes it?
  2. What complications and subsequent treatments did the patient encounter after his initial colon cancer surgery?
  3. What does this medical case suggest about preventive measures and the use of minimally invasive surgeries in treating colon cancer and its complications?

Doctor’s Tip

A helpful tip a doctor might give to a patient about sigmoidectomy is to follow post-operative instructions closely, including proper wound care, taking prescribed medications, and attending follow-up appointments. It is also important to maintain a healthy lifestyle with a balanced diet, regular exercise, and staying hydrated to support healing and prevent complications. If any unusual symptoms or problems arise, it is crucial to contact your healthcare provider promptly for evaluation and treatment.

Suitable For

Patients who are typically recommended for sigmoidectomy include those with severe cases of sigmoid volvulus, recurrent sigmoid volvulus, or those who have complications from the condition such as bowel obstruction, perforation, or necrosis. Patients with a history of chronic constipation, neurological diseases affecting bowel function, or previous surgeries for colon-related issues may also be candidates for sigmoidectomy. Additionally, patients who have a long sigmoid colon or other anatomical abnormalities that predispose them to sigmoid volvulus may be recommended for sigmoidectomy as a preventive measure.

Timeline

Before sigmoidectomy:

  1. Patient undergoes surgery for colon cancer.
  2. Patient develops a hernia at the site of the surgery scar and undergoes minimally invasive surgery to repair it.
  3. Over five years later, patient experiences abdominal pain and bloating, leading to a diagnosis of sigmoid volvulus (SV).
  4. Doctors initially untwist the colon using a scope, but the condition recurs two months later.

After sigmoidectomy:

  1. Patient undergoes another minimally invasive surgery to remove the twisted part of the colon and reconnect it using a surgical stapler.
  2. Surgery is successful with minimal blood loss and no complications.
  3. Five years later, the patient is doing well with no recurrence of SV or any other complications.
  4. The case highlights the need for preventive measures against SV in patients undergoing laparoscopic surgery for colon cancer and the success of repeat minimally invasive surgeries with careful patient selection.

What to Ask Your Doctor

  1. What is sigmoidectomy and why is it being recommended for me?
  2. What are the potential risks and complications associated with sigmoidectomy?
  3. How long is the recovery process after sigmoidectomy and what can I expect during this time?
  4. Are there any alternative treatment options available for my condition?
  5. Will I need any additional procedures or surgeries in the future after sigmoidectomy?
  6. How often do patients experience complications like sigmoid volvulus after colon cancer surgery?
  7. What preventive measures can be taken to reduce the risk of developing sigmoid volvulus after surgery?
  8. What are the long-term effects or complications I should be aware of after undergoing sigmoidectomy?
  9. How often should I follow up with you or a specialist after the surgery?
  10. Are there any lifestyle changes or dietary recommendations I should consider following sigmoidectomy?

Reference

Authors: Masui H, Kawada K, Inamoto S, Wada T, Sakai Y, Obama K. Journal: Surg Case Rep. 2024 Jun 28;10(1):163. doi: 10.1186/s40792-024-01961-3. PMID: 38937390