Laparoscopic Deloyers Procedure as a Salvage Technique for Colorectal Anastomosis: An Alternative to Total Colectomy
DOI:
https://doi.org/10.22516/25007440.935Keywords:
Colectomy, Surgical anastomosis, Colostomy, Ileocecal valveAbstract
Introduction: The Deloyers procedure is a valuable technique used in reconstructing bowel transit following an extended left colectomy, a Hartmann-type colostomy, or repeated colon resections. It enables the creation of a tension-free colorectal or coloanal anastomosis.
Case presentation: A 60-year-old female patient presented for consultation regarding the closure of a colostomy. Her medical history included segmental colectomy of the sigmoid and descending colon, resulting in a Hartmann-type colostomy due to complicated diverticulitis. The patient underwent laparoscopic surgery, during which a segment of the transverse colon with a short mesocolon was identified. Due to the complete release of the colon, a colorectal anastomosis could not be performed. As an alternative to preserving the ileocecal valve and achieving a tension-free colorectal anastomosis, the patient underwent the Deloyers procedure.
Discussion: The Deloyers procedure involves tension-free anastomosis between the right colon and the rectum or anus. It includes complete mobilization and a 180° counterclockwise rotation of the hepatic angle and the right colon. The right and middle colic vessels are divided, while preserving the ileocolic pedicle and the ileocecal valve, thus avoiding the need for total colectomy and ileorectal anastomosis, which may yield unsatisfactory functional outcomes.
Conclusion: The Deloyers procedure represents a viable alternative to ileorectal or ileoanal anastomosis, offering satisfactory functional outcomes.
Downloads
References
Manceau G, Karoui M, Breton S, Blanchet AS, Rousseau G, Savier E, et al. Right Colon to Rectal Anastomosis (Deloyers Procedure) as a Salvage Technique for Low Colorectal or Coloanal Anastomosis: Postoperative and Long-Term Outcomes. Dis Colon Rectum. 2012;55(3):363-8. https://doi.org/10.1097/DCR.0b013e3182423f83
Sugarbaker PH. Progressive release of the left colon for a tension-free colorectal or coloanal anastomosis. Cancer Treat Res. 1996;82:255-61. https://doi.org/10.1007/978-1-4613-1247-5_16
Deloyers L. Suspension of the right colon permits without exception preservation of the anal sphincter after extensive colectomy of the transverse and left colon (including rectum). Technic -indications- immediate and late results. Lyon Chir. 1964;60:404-13.
Sciuto A, Grifasi C, Pirozzi F, Leon P, Pirozzi REM, Corcione F. Laparoscopic Deloyers procedure for tension-free anastomosis after extended left colectomy: technique and results. Tech Coloproctol. 2016;20(12):865-9. https://doi.org/10.1007/s10151-016-1562-z
Martín Martín GP, Yang I, Zakaria A, Kim SH. Procedimiento laparoscópico de Deloyers para anastomosis sin tensión en la colectomía izquierda extendida [Internet]. aecirujanos.es. [consultado el 25 de junio de 2022]. Disponible en: https://www.aecirujanos.es/Procedimiento-laparoscopico-de-Deloyers-para-anastomosis-sin-tension-en-la-colectomia-izquierda-extendida_es_300_41_0_1_14.html#!
Tang ST, Yang Y, Wang G Bin, Tong QS, Mao YZ, Wang Y, et al. Laparoscopic extensive colectomy with transanal Soave pull-through for intestinal neuronal dysplasia in 17 children. World J Pediatr. 2010;6(1):50-4. https://doi.org/10.1007/s12519-010-0006-5
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 Revista colombiana de Gastroenterología
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Aquellos autores/as que tengan publicaciones con esta revista, aceptan los términos siguientes:
Los autores/as ceden sus derechos de autor y garantizarán a la revista el derecho de primera publicación de su obra, el cuál estará simultáneamente sujeto a la Licencia de reconocimiento de Creative Commons que permite a terceros compartir la obra siempre que se indique su autor y su primera publicación en esta revista.
Los contenidos están protegidos bajo una licencia de Creative Commons Reconocimiento-NoComercial-SinObraDerivada 4.0 Internacional.
| Article metrics | |
|---|---|
| Abstract views | |
| Galley vies | |
| PDF Views | |
| HTML views | |
| Other views | |
