Vieta J O, Blanco R, Valentini G R
Dis Colon Rectum. 1976 Sep;19(6):542-52. doi: 10.1007/BF02590951.
Two patients had duodenocolic fistulas, each following a carcinoma of the colon in the area of the hepatic flexure that had perforated into the duodenum. The first patient was treated by a radical pancreatoduodenectomy with right colectomy; the second by subtotal colectomy with excision of the duodenal wall and suture. Both patients are alive and without evidence of recurrent disease. In addition, the first patient had two other primary carcinomas, in the cecum and in the stomach, and the second patient had another primary in the sigmoid. The definitive procedure had to be adjusted to encompass all lesions. The radical operation in one stage seems to be the preferred procedure and certainly is most satisfactory as a cancer operation. Our patient treated by this procedure has survived more than 11 years. An intestinal fistula related to colonic carcinoma, evan though rare, should not be considered as a separate entity. Treatment of the cancer with an en-bloc resection of the communicating organs should be employed if possible.
两名患者患有十二指肠结肠瘘，均继发于肝曲处结肠癌穿孔至十二指肠。首例患者接受了根治性胰十二指肠切除术加右半结肠切除术；第二例接受了次全结肠切除术，切除十二指肠壁并缝合。两名患者均存活，无疾病复发迹象。此外，首例患者还有另外两处原发性癌，分别位于盲肠和胃，第二例患者在乙状结肠还有另一处原发性癌。最终手术方案必须进行调整以涵盖所有病变。一期根治性手术似乎是首选方案，作为癌症手术当然也是最令人满意的。接受此手术治疗的我们的患者已存活超过11年。与结肠癌相关的肠瘘，尽管罕见，但不应被视为一个独立的实体。如有可能，应采用整块切除受累器官治疗癌症。
