Liu Pei-Gen, Feng Pan-Feng, Chen Xiang-Fan
Department of General Surgery, Central Hospital of Panzhihua City, Panzhihua 617000, Sichuan Province, China.
Department of Pharmacy, Affiliated Hospital 2 of Nantong University, Nantong 226001, Jiangsu Province, China.
World J Clin Cases. 2023 Feb 16;11(5):1049-1057. doi: 10.12998/wjcc.v11.i5.1049.
Hepatic colon carcinoma invading the duodenum is not common in clinical practice. Surgical treatment of colonic hepatic cancer that invades the duodenum is difficult, and the surgical risk is high.
To discuss the efficacy and safety of duodenum-jejunum Roux-en-Y anastomosis for the treatment of hepatic colon carcinoma invading the duodenum.
From 2016 to 2020, 11 patients from Panzhihua Central Hospital diagnosed with hepatic colon carcinoma were enrolled in this study. Clinical and therapeutic effects and prognostic indicators were retrospectively analyzed to determine the efficacy and safety of our surgical procedures. All patients underwent radical resection of right colon cancer combined with duodenum-jejunum Roux-en-Y anastomosis.
The median tumor size was 65 mm (r50-90). Major complications (Clavien-DindoI-II) occurred in 3 patients (27.3%); the average length of hospital stay was 18.09 ± 4.21 d; and only 1 patient (9.1%) was readmitted during the 1 mo after the surgery. The 30-d mortality rate was 0%. After a median follow-up of 41 m (r7-58), the disease-free survival at 1, 2, and 3 years was 90.9%, 90.9% and 75.8%, respectively; the overall survival at 1, 2, and 3 years was 90.9%.
In selected patients, radical resection of right colon cancer combined with duodenum-jejunum Roux-en-Y anastomosis is clinically effective, and the complications are manageable. The surgical procedure also has an acceptable morbidity rate and mid-term survival.
肝曲结肠癌侵犯十二指肠在临床实践中并不常见。肝曲结肠癌侵犯十二指肠的手术治疗困难，手术风险高。
探讨十二指肠-空肠Roux-en-Y吻合术治疗肝曲结肠癌侵犯十二指肠的疗效及安全性。
选取2016年至2020年攀枝花市中心医院确诊的11例肝曲结肠癌患者纳入本研究。回顾性分析临床及治疗效果和预后指标，以确定我们手术方法的疗效和安全性。所有患者均接受右半结肠癌根治性切除术并联合十二指肠-空肠Roux-en-Y吻合术。
肿瘤中位大小为65 mm（范围50 - 90）。3例患者（27.3%）发生主要并发症（Clavien-Dindo I-II级）；平均住院时间为18.09±4.21天；术后1个月内仅1例患者（9.1%）再次入院。30天死亡率为0%。中位随访41个月（范围7 - 58）后，1年、2年和3年的无病生存率分别为90.9%、90.9%和75.8%；1年、2年和3年的总生存率为90.9%。
对于选定的患者，右半结肠癌根治性切除术联合十二指肠-空肠Roux-en-Y吻合术在临床上是有效的，并发症可控。该手术方法的发病率和中期生存率也可接受。
