Saiura Akio, Yamamoto Junji, Ueno Masashi, Koga Rintaro, Seki Makoto, Kokudo Norihiro
Department of Gastroenterological Surgery, Cancer Institute Hospital, Tokyo, Japan.
Dis Colon Rectum. 2008 Oct;51(10):1548-51. doi: 10.1007/s10350-008-9318-0. Epub 2008 May 3.
Surgical indications for colon cancer directly invading the pancreas head are controversial.
Between 1957 and 2007, a total of 12 patients (8 men) underwent pancreaticoduodenectomy combined with right hemicolectomy for colon cancer involving the pancreas head.
Mean age was 58 (range, 34-77) years. Fistula formation was observed in five patients (41 percent) preoperatively. Tumor involvement was duodenum only (n = 4), duodenum/pancreas (n = 3), stomach/pancreas (n = 1), duodenum/stomach (n = 2), duodenum/liver (n = 1), and pancreas only (n = 1). Only one postoperative death was encountered. Histologic examination showed malignant invasion to the pancreas head in nine cases (75 percent). Overall one-year, three-year and, five-year survival rates after surgery were 75, 66, and 55 percent, respectively. Five patients (41 percent) survived for more than ten 10 years.
Pancreaticoduodenectomy for advanced colon cancer invading the pancreas or duodenum provides favorable long-term survival.
结肠癌直接侵犯胰头的手术指征存在争议。
1957年至2007年间，共有12例患者（8例男性）因结肠癌侵犯胰头接受了胰十二指肠切除术联合右半结肠切除术。
平均年龄为58岁（范围34 - 77岁）。5例患者（41%）术前观察到瘘管形成。肿瘤累及情况为仅十二指肠（n = 4）、十二指肠/胰腺（n = 3）、胃/胰腺（n = 1）、十二指肠/胃（n = 2）、十二指肠/肝脏（n = 1）以及仅胰腺（n = 1）。术后仅1例死亡。组织学检查显示9例（75%）存在胰头恶性侵犯。术后总体1年、3年和5年生存率分别为75%、66%和55%。5例患者（41%）存活超过10年。
针对侵犯胰腺或十二指肠的进展期结肠癌行胰十二指肠切除术可提供良好的长期生存。
