Department of Surgery, Gil Hospital, Gachon University of Medicine of Science School of Medicine, Incheon, Korea.
Yonsei Med J. 2009 Dec 31;50(6):803-6. doi: 10.3349/ymj.2009.50.6.803. Epub 2009 Dec 18.
We undertook this study to analyze clinical features and surgical outcome of en bloc resections of the right side colon cancer directly invading duodenum and/or pancreatic head.
The records of all patients who underwent en bloc resection of duodenum and/or pancreas for right colon cancers were analyzed retrospectively. From September 1994 to September 2006, 1,016 patients underwent curative right hemicolectomy. Nine patients (0.9%) had en bloc resection of a right side colon cancer with duodenum or pancreatic head invasion.
The median operative time was 320 minutes (range, 200-420) and the median blood loss was 700 mL (range, 100-2,000). The mean size of tumor was 6.6 cm (range, 3.2-10.7). The mean preoperative carcinoembryonic antigen (CEA) was 10.6 ng/mL (range, 0.2-50.8). There was no 30 day perioperative mortality. The median disease-free survival was 23.5 months [95% confidence interval (CI) 5.2-41.8] and the median overall survival was 28.1 months (95% CI 9.7-46.5).
In patients with locally advanced right side colon cancer that directly invades the duodenum or pancreas can be safely resected with curative potential with minimum morbidity and mortality. Long term disease free survival can occur in a significant number of patients undergoing curative en bloc resection in this particular subset of patients.
本研究旨在分析整块切除侵犯十二指肠和/或胰头的右侧结肠癌的临床特征和手术结果。
回顾性分析所有接受整块切除十二指肠和/或胰头的右半结肠癌患者的记录。1994 年 9 月至 2006 年 9 月，1016 例患者接受根治性右半结肠切除术。9 例（0.9%）患者行整块切除侵犯右半结肠的肿瘤合并十二指肠或胰头侵犯。
中位手术时间为 320 分钟（范围 200-420 分钟），中位出血量为 700ml（范围 100-2000ml）。肿瘤平均大小为 6.6cm（范围 3.2-10.7cm）。术前癌胚抗原（CEA）平均值为 10.6ng/ml（范围 0.2-50.8ng/ml）。无 30 天围手术期死亡。中位无病生存期为 23.5 个月[95%置信区间（CI）5.2-41.8]，中位总生存期为 28.1 个月[95%CI 9.7-46.5]。
对于局部晚期侵犯十二指肠或胰头的右侧结肠癌患者，整块切除可达到根治性，且发病率和死亡率低。在这一特定患者亚组中，接受根治性整块切除的患者中有相当一部分可获得长期无病生存。
