Sir,
I read with great interest an article entitled, ‘Natural orifice’ transcolostomy full-thickness excision of the colonic tumour’ by Pricolo.[1] It is an interesting case and managed very nicely. I would like to congratulate the author for his nice effort to report such a novel technique. However, I have a few observations in this connection.
In the index case, the procedure was performed through colostomy and labelled as a natural orifice’ transcolostomy full-thickness excision of the colonic tumour. I would like to state that colostomy is an artificial opening. The procedure performed through an artificial opening cannot be considered as natural orifice technique.
I would also like to state that the author had used term polyp and tumour interchangeably throughout the manuscript. It is preferable to use uniform terminology whichever is more suitable. When tumour produces, macroscopically visible projection above the visible surface is termed as polyp.[2] I feel that polyp is more appropriate according to the definition as the tumour is a broad term.
Although there is no reported case of such technique in the literature, there is anecdotal evidence that such technology had been performed for the removal of polyp through ileostomy (www.aapc.com/memberarea/forums/10978-removal-polyp-inside-ileostomy-scope.html).
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Conflicts of interest
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REFERENCES
- 1.Pricolo VE. 'Natural orifice’ transcolostomy full-thickness excision of colonic tumour. J Minim Access Surg. 2017;13:219–21. doi: 10.4103/0972-9941.199608. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 2.Kumar V, Abbas AK, Aster JC, editors. Neoplasia. Robbins and Cotran Pathological Basis of Disease. 9th ed. Philadelphia: Elsevier; 2015. pp. 265–340. [Google Scholar]