局部晚期右半结肠癌侵犯十二指肠的诊断与外科治疗原则

The diagnosis and treatment of locally advanced right-sided colon cancer adherent to or invading duodenum

临床工作中局部晚期右半结肠癌侵犯十二指肠的病例并不罕见,需要引起外科医生的重视,使部分确有治愈机会的患者得到应有的治疗。患者的主要症状与右半结肠癌类似,CT和MRI有助于明确十二指肠是否受侵。超声内镜也有着重要的诊断价值。对可疑侵犯十二指肠的病例可先试行新辅助治疗,待降期后再考虑手术治疗。术中探查发现肿瘤侵犯十二指肠时应根据具体情况采用不同的手术方法。

The cases of locally advanced right-sided colon cancer adherent to or invading duodenum are not rare, and it is necessary for the surgeons to pay more attention, so as to make some cases get opportunity to cure they deserve. It is similar in the main symptoms between these cases and the cases of right-sided colon cancer. CT scan and MRI are helpful to determine whether the duodenum is invaded, and the endoscopic ultrasonography is an important means and of great value. For the suspected cases adherent to or invading duodenum, the operation is recommended after neoadjuvant chemotherapy. Reasonable and individual surgical procedures are selected when the tumor adherent to or invading duodenum is found during the operation.