Objective： The aim of the study was to discuss surgical treatment of right colon carcinoma of hepatic flexure invading the duodenum. Methods： The 65 patients with right colon carcinoma of hepatic flexure invading th...Objective： The aim of the study was to discuss surgical treatment of right colon carcinoma of hepatic flexure invading the duodenum. Methods： The 65 patients with right colon carcinoma of hepatic flexure invading the duodenum, treated in our department from 1987 to 2007, were included in this study. Their clinicopathological data were retrospectively reviewed and analyzed. All the cases were divided into three types （local invasion, regional invasion, and cancer with internal fistula） according to duodenal defect, including local invasion （ 2.0 cm）, wide invasion （ 2.0 cm） and the presence of internal fistula. Results： The 25 patients with local invasion underwent en bloc resection of the duodenal wall. Pedicled ileal flap was used to cover the large duodenal defect measuring 2.0–3.0 cm in 5 patients. Dudenojejunostomy was used to reconstruct the large defect measuring more than 5 cm in 3 patients. Conservative resection of right-sided colon was performed in 18 patients with wide invasion. Four patients underwent pancreaticoduodenectomy combined with right hemicolectomy for colon cancer involving the pancreatic head. Ten cases underwent duodenal diverticularization. One patient with anastomotic leakage healed within 3 weeks. Other patients were cured without postoperative complications. The total 3-and 5-year survival rates after surgery were 53.8% and 9.2%, respectively. Conclusion： The surgical procedure to be performed is usually decided according to the cancer location, extent, and duodenal defect and invasion, which are important for prolonging life time, improving of quality of life and prognosis in these patients.展开更多
文摘Objective： The aim of the study was to discuss surgical treatment of right colon carcinoma of hepatic flexure invading the duodenum. Methods： The 65 patients with right colon carcinoma of hepatic flexure invading the duodenum, treated in our department from 1987 to 2007, were included in this study. Their clinicopathological data were retrospectively reviewed and analyzed. All the cases were divided into three types （local invasion, regional invasion, and cancer with internal fistula） according to duodenal defect, including local invasion （ 2.0 cm）, wide invasion （ 2.0 cm） and the presence of internal fistula. Results： The 25 patients with local invasion underwent en bloc resection of the duodenal wall. Pedicled ileal flap was used to cover the large duodenal defect measuring 2.0–3.0 cm in 5 patients. Dudenojejunostomy was used to reconstruct the large defect measuring more than 5 cm in 3 patients. Conservative resection of right-sided colon was performed in 18 patients with wide invasion. Four patients underwent pancreaticoduodenectomy combined with right hemicolectomy for colon cancer involving the pancreatic head. Ten cases underwent duodenal diverticularization. One patient with anastomotic leakage healed within 3 weeks. Other patients were cured without postoperative complications. The total 3-and 5-year survival rates after surgery were 53.8% and 9.2%, respectively. Conclusion： The surgical procedure to be performed is usually decided according to the cancer location, extent, and duodenal defect and invasion, which are important for prolonging life time, improving of quality of life and prognosis in these patients.
