Curley S A, Evans D B, Ames F C
Department of Surgical Oncology, University of Texas M. D. Anderson Cancer Center, Houston 77030.
J Am Coll Surg. 1994 Nov;179(5):587-92.
Approximately 10 percent of carcinomas of the colon and rectum adhere to adjacent organs or structures, which rarely include the duodenum or pancreas.
To confirm the importance of aggressive operative management in patients with locally advanced carcinoma of the colon invading the duodenum or pancreatic head, we reviewed the medical records of 12 patients who underwent an extended resection for a right-sided carcinoma of the colon involving the duodenum or the pancreatic head, or both.
All patients underwent an extended right hemicolectomy, including en bloc pancreaticoduodenectomy (seven patients) or lateral duodenectomy (five patients). The mean operative blood loss was 627 mL, and there were no postoperative deaths. Malignant invasion of the duodenum or pancreas was confirmed in all 12 patients, but only three (25 percent) had lymph node metastases. The median survival period for all 12 patients was 32 months. However, the median survival period for the eight patients still alive without recurrent or metastatic disease was 42 months.
In patients with locally advanced carcinoma of the colon involving the duodenum or pancreatic head long-term survival can be achieved by en bloc resection.
约10%的结肠癌和直肠癌会侵犯相邻器官或结构，其中很少包括十二指肠或胰腺。
为证实积极手术治疗对局部晚期结肠癌侵犯十二指肠或胰头患者的重要性，我们回顾了12例因右侧结肠癌侵犯十二指肠或胰头或两者而接受扩大切除术患者的病历。
所有患者均接受了扩大右半结肠切除术，包括整块胰十二指肠切除术（7例）或十二指肠外侧切除术（5例）。平均手术失血量为627毫升，无术后死亡病例。所有12例患者均证实有十二指肠或胰腺的恶性侵犯，但只有3例（25%）有淋巴结转移。12例患者的中位生存期为32个月。然而，8例无复发或转移疾病存活患者的中位生存期为42个月。
对于局部晚期结肠癌侵犯十二指肠或胰头的患者，整块切除可实现长期生存。
