Cargando…
Laparoscopic Management of Mobile Cecum
BACKGROUND AND OBJECTIVES: The mobile cecum is an embryologic abnormality and has been associated with functional colon disease (chronic constipation and irritable bowel syndrome). However, unlike functional disease, the primary treatment is operative, using laparoscopic cecopexy. We compare the epi...
Autores principales: | , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Society of Laparoendoscopic Surgeons
2016
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5080399/ https://www.ncbi.nlm.nih.gov/pubmed/27807396 http://dx.doi.org/10.4293/JSLS.2016.00076 |
_version_ | 1782462704686989312 |
---|---|
author | Gomes, Carlos Augusto Soares, Cleber Catena, Fausto Di Saverio, Salomone Sartelli, Massimo Gomes, Camila Couto Gomes, Felipe Couto |
author_facet | Gomes, Carlos Augusto Soares, Cleber Catena, Fausto Di Saverio, Salomone Sartelli, Massimo Gomes, Camila Couto Gomes, Felipe Couto |
author_sort | Gomes, Carlos Augusto |
collection | PubMed |
description | BACKGROUND AND OBJECTIVES: The mobile cecum is an embryologic abnormality and has been associated with functional colon disease (chronic constipation and irritable bowel syndrome). However, unlike functional disease, the primary treatment is operative, using laparoscopic cecopexy. We compare the epidemiology and pathophysiology of mobile cecum syndrome and functional colon disease and propose diagnostic and treatment guidelines. METHOD: This study was a case–control series of 15 patients who underwent laparoscopic cecopexy. Age, gender, recurrent abdominal pain, and constipation based on Rome III criteria were assessed. Ileocecal–appendiceal unit displacement was graded as follows: I (cecum retroperitoneal or with little mobility); II (wide mobility, crossing the midline); and III (maximum mobility, reaching the left abdomen). Patients with Grades II and III underwent laparoscopic cecopexy. The clinical outcomes were evaluated according to modified Visick's criteria, and postoperative complications were assessed according to the Clavien-Dindo classification. RESULTS: The mean age was 31.86 ± 12.02 years, and 13 patients (86.7%) were women. Symptoms of constipation and abdominal pain were present in 14 (93.3%) and 11 (73.3%), respectively. Computed tomography was performed in 8 (53.3%) patients. The mean operative time was 41 ± 6.66 min. There were no postoperative infections. One (7.8%) patient was classified as Clavien Dindo IIIb and all patients were classified as Visick 1 or 2. CONCLUSION: Many patients with clinical and epidemiological features of functional colon disease in common in fact have an anatomic anomaly, for which the treatment of choice is laparoscopic cecopexy. New protocols should be developed to support this recommendation. |
format | Online Article Text |
id | pubmed-5080399 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | Society of Laparoendoscopic Surgeons |
record_format | MEDLINE/PubMed |
spelling | pubmed-50803992016-11-02 Laparoscopic Management of Mobile Cecum Gomes, Carlos Augusto Soares, Cleber Catena, Fausto Di Saverio, Salomone Sartelli, Massimo Gomes, Camila Couto Gomes, Felipe Couto JSLS Scientific Papers BACKGROUND AND OBJECTIVES: The mobile cecum is an embryologic abnormality and has been associated with functional colon disease (chronic constipation and irritable bowel syndrome). However, unlike functional disease, the primary treatment is operative, using laparoscopic cecopexy. We compare the epidemiology and pathophysiology of mobile cecum syndrome and functional colon disease and propose diagnostic and treatment guidelines. METHOD: This study was a case–control series of 15 patients who underwent laparoscopic cecopexy. Age, gender, recurrent abdominal pain, and constipation based on Rome III criteria were assessed. Ileocecal–appendiceal unit displacement was graded as follows: I (cecum retroperitoneal or with little mobility); II (wide mobility, crossing the midline); and III (maximum mobility, reaching the left abdomen). Patients with Grades II and III underwent laparoscopic cecopexy. The clinical outcomes were evaluated according to modified Visick's criteria, and postoperative complications were assessed according to the Clavien-Dindo classification. RESULTS: The mean age was 31.86 ± 12.02 years, and 13 patients (86.7%) were women. Symptoms of constipation and abdominal pain were present in 14 (93.3%) and 11 (73.3%), respectively. Computed tomography was performed in 8 (53.3%) patients. The mean operative time was 41 ± 6.66 min. There were no postoperative infections. One (7.8%) patient was classified as Clavien Dindo IIIb and all patients were classified as Visick 1 or 2. CONCLUSION: Many patients with clinical and epidemiological features of functional colon disease in common in fact have an anatomic anomaly, for which the treatment of choice is laparoscopic cecopexy. New protocols should be developed to support this recommendation. Society of Laparoendoscopic Surgeons 2016 /pmc/articles/PMC5080399/ /pubmed/27807396 http://dx.doi.org/10.4293/JSLS.2016.00076 Text en © 2016 by JSLS, Journal of the Society of Laparoendoscopic Surgeons. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives License (http://creativecommons.org/licenses/by-nc-nd/3.0/us/), which permits for noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited and is not altered in any way. |
spellingShingle | Scientific Papers Gomes, Carlos Augusto Soares, Cleber Catena, Fausto Di Saverio, Salomone Sartelli, Massimo Gomes, Camila Couto Gomes, Felipe Couto Laparoscopic Management of Mobile Cecum |
title | Laparoscopic Management of Mobile Cecum |
title_full | Laparoscopic Management of Mobile Cecum |
title_fullStr | Laparoscopic Management of Mobile Cecum |
title_full_unstemmed | Laparoscopic Management of Mobile Cecum |
title_short | Laparoscopic Management of Mobile Cecum |
title_sort | laparoscopic management of mobile cecum |
topic | Scientific Papers |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5080399/ https://www.ncbi.nlm.nih.gov/pubmed/27807396 http://dx.doi.org/10.4293/JSLS.2016.00076 |
work_keys_str_mv | AT gomescarlosaugusto laparoscopicmanagementofmobilececum AT soarescleber laparoscopicmanagementofmobilececum AT catenafausto laparoscopicmanagementofmobilececum AT disaveriosalomone laparoscopicmanagementofmobilececum AT sartellimassimo laparoscopicmanagementofmobilececum AT gomescamilacouto laparoscopicmanagementofmobilececum AT gomesfelipecouto laparoscopicmanagementofmobilececum |