Laparoscopic Removal of a Gastric Trichobezoar in an 8-Year-Old Girl: a Case Report

Gastric trichobezoars are commonly observed in young women with trichotillomania and trichophagia. We encountered an 8-year-old girl who had trichotillomania and trichophagia with abdominal pain and a mass, which was diagnosed as a large gastric trichobezoar. On physical examination, a huge, firm nontender mobile mass was palpated in her epigastrium. An upper gastrointestinal series and abdominal computed tomography (CT) scan showed a large mass in the stomach. Endoscopic removal was tried but failed. Laparoscopic removal was therefore performed. The trichobezoar was successfully retrieved through a gastrotomy and removed through an extended umbilical trocar incision. This case demonstrates that laparoscopic removal of large gastric trichobezoars is feasible and safe without a large abdominal incision.

Laparoscopic right hemicolectomy with D3 lymph node dissection for right colon cancer / 中国微创外科杂志

Objective To explore the efficacy of laparoscopic right hemicoloectomy with D3 lymph node dissection for right colon cancer based on a no-touch isolation technique.Methods A total of 87 cases was given laparoscopic right hemicoloectomy with D3 lymph node dissection from June 1996 to August 2004.The lymph nodes along the surgical trunk at the root of the superior mesenteric vessels were initially dissected.And the right transverse colon and the ascending colon were isolated.Then a transection of the bowel and an end-to-end enteroanastomosis were conducted extracorporeally. Results The operative time was 120～397 min(mean,212 min).The total number of lymph nodes harvested was 9～91(mean,35),including 0～50 (mean,17.5) paracolic and epicolic lymph nodes,0～20(mean,10.4) intermesenteric nodes,and 0～39(mean,7.5) artery root nodes.The postoperative morbidity rate was 16.1%(14/87),including incision infection in 8 cases(9.2%),ileus in 2 cases(2.3%),perianastomotic inflammation in 2 cases(2.3%),and intraabdominal abscess and fluid collection in 2 cases(2.3%).A total of 84 cases were followed for 12～113 months(mean,45 months).The survival time was over 3 years in 30 cases.Meanwhile a loss to follow-up was recorded in 36 cases.Conclusions Based on the principle of en bloc resection of tumor,a proper approach with clear access,low bleeding,and good visualization is the key to perform laparoscopic right hemicoloectomy.