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首页> 外文期刊>Einstein (So Paulo) >En bloc pancreaticoduodenectomy and right hemicolectomy to treat locally advanced right colon cancer: report of three cases
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En bloc pancreaticoduodenectomy and right hemicolectomy to treat locally advanced right colon cancer: report of three cases

机译：整体胰十二指肠切除术和右半结肠切除术治疗局部晚期右结肠癌：三例报告

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ABSTRACTAlthough colorectal tumors are fairly common surgical conditions, 5 to 12% of these tumors are locally advanced (T4 tumors) upon diagnosis. In this particular situation, the efficacy of en bloc multivisceral resection has been proven. When right-colon cancer invades the proximal duodenum or even the pancreatic head, a challenging dilemma arises due to complexity of the curative surgical procedure. Therefore, en bloc pancreaticoduodenectomy with right hemicolectomy should be performed to obtain free margins. The present study reports three cases of locally advanced right-colon cancer invading the proximal duodenum. All of these cases underwent successful en bloc pancreaticoduodenectomy plus right hemicolectomy, with no death occurrence. Long-term survival was observed in two cases (30 and 50 months). In the third case, the patient did not present any recurrence twelve months after surgical treatment. Multivisceral resection with en bloc pancreaticoduodenectomy should be considered for patients who present acceptable risk for major surgery and no distant dissemination. This approach seems justified since the length of postoperative survival is longer in radically ressected groups (R0) than in palliativelly resected groups (R1-2).
机译：摘要尽管结直肠肿瘤是相当常见的外科疾病，但诊断后这些肿瘤中有5％至12％是局部进展的（T4肿瘤）。在这种特殊情况下，整体多脏器切除术的功效已得到证明。当右结肠癌侵袭十二指肠近端甚至胰头时，由于治愈性外科手术的复杂性而引起了难题。因此，应行整体胰十二指肠切除术和右半结肠切除术以获取自由切缘。本研究报告了三例侵犯十二指肠近端的局部晚期右结肠癌。所有这些病例均成功进行了全胰十二指肠切除术加右半结肠切除术，无死亡发生。在两个案例中（30和50个月）观察到长期生存。在第三种情况下，患者在手术治疗后十二个月未出现任何复发。对于大手术可接受的风险且无远处扩散的患者，应考虑采用全胰十二指肠切除术进行多脏器切除。这种方法似乎是合理的，因为根治性切除组（R0）的术后生存期比姑息切除组（R1-2）更长。

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