右半结肠癌致十二指肠手术缺损带血管蒂全层回肠壁修复术

Repair of duodenal operatie defect due to infiltration of right hemi-colonic carcinoma with all layers of pedicled ileac flap

1986-2002年10月间,经手术治疗37例右半结肠癌侵及十二指肠。其中8例将肿块直接从十二指肠壁上分离,23例将肿块与部分十二指肠壁整块切除。根据十二指肠缺损面积大小,采用直接缝合5例,空肠十二指肠Rous-eny吻合5例,带血管蒂全层回肠片修补13例。不能切除行胃空肠吻合加盲肠造口6例,结果术后死亡7例;3例十二指肠瘘,4例MSOF。结论认为当右半结肠癌侵及十二指肠时,应侧重于手术的彻底性及合理性,缺损面积大的采用全层回肠补片修补。以减少局部癌组织残留及术后复发,取得较好疗效,延长生存期。

Operative treatment of 37 cases of patievts with right hemi-colonic carcinoma and infiltrated duodenum from 1986 to October 2002.In which :8 cases ,dissoaation of the mass from duodenal wall directly :23 cases resection of the mass ard partial duodeal wall BY duodenaldefectarea,5casessuturedirectly.5casesejejuno-duodenalRoux-enyanastomosis,13cases ,repair of the defect with all layers of pedicled ileac flap ,6cases gastro-jejundl anastomosis and csostomy.After operation .7cases death,3cases duodenal fitula andA 4cases msof.Author consider:treatment of the patients with right hemi-colonic carcinoma.and infiltratsd duodeum,operation should be entire and rational To larger duodenal defect area,adopting all layers of peclicledilac flap to repair it to redua the residue of locac tumour tissue and postoperative recurrence and then to get good treatmentive result and prolong survival time.