Management of patients with carcinoma of the right colon invading the duodenum or pancreatic head

Autor: Jean-Jacques Tuech, Jean-Paul Joly, Jean-Marc Regimbeau, Pierre Verhaeghe, Patrick Pessaux, Thierry Yzet, Olivier Brehant, Sushil Deshpande, Denis Chatelain, B. Lefebure, Frédéric Dumont, Jean-Pierre Arnaud, François Mauvais, David Fuks
Přispěvatelé: CHU Amiens-Picardie, Départment de Statistiques Bio-médicales, Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM)-PRES Université Nantes Angers Le Mans (UNAM), Département de chirurgie [CHU Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Service de chirurgie digestive (Centre Hospitalier de Beauvais), Centre Hospitalier de Beauvais, Procédés Alimentaires et Microbiologiques [Dijon] (PAM), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université de Bourgogne (UB)-AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement, Service d'Hépato-Gastroentérologie, Service de chirurgie digestive [CHU Rouen], Hémodynamique, Interaction Fibrose et Invasivité tumorales Hépatiques (HIFIH), Université d'Angers (UA), Department of Digestive Surgery. Hôpital Nord
Rok vydání: 2008
Předmět:
Zdroj: International Journal of Colorectal Disease
International Journal of Colorectal Disease, Springer Verlag, 2008, 23 (5), pp.477-481. ⟨10.1007/s00384-007-0409-5⟩
ISSN: 1432-1262
0179-1958
DOI: 10.1007/s00384-007-0409-5
Popis: International audience; Background Only few case series have been published about locally advanced carcinoma of the right colon invading the duodenum or pancreas (CRCDP). We report results of a retrospective study about this rare entity focusing on management and prognosis. Methods We reviewed the complete data of patients operated for CRCDP between 1988 and 2005 in four French digestive-surgery departments. Results Fifteen patients were managed [12 men, 3 women, mean age 63 years (43–86)]. These patients underwent attempted curative en bloc resection including right colectomy: 12 were treated by partial duodenectomy (tumours involving only a part of the duodenum); 3 were treated by pancreaticoduodenectomy. All tumours resected had clear resection margins (R0). About 53% of patients had hepatic metastases, duodenocolic fistula, carcinomatosis, abscess or perforation at presentation. Surgery was performed in emergency in 26% of cases. About 20% of patients had serious postoperative complications (heart failure, bile duct necrosis, septic shock), and three other patients had postoperative anastomotic leaks. No patient experienced duodenal fistula after partial duodenectomy. The mean median survival in resected patients was 22 months (0–122). Overall 1 and 3 years survival were 68% (n = 7) and 56% (n = 4). Despite clear resection margins in all patients, 26% of patients developed recurrence (duodenal wall resection n = 3; pancreaticoduodenectomy n = 1). Conclusion Morbidity and mortality after colectomy and en bloc partial duodenectomy or pancreaticoduodenectomy are high but in selected cases could offer prolonged survival. Aggressive surgery including major resection should be performed to obtain clear resection margins even in case of complicated forms.
Databáze: OpenAIRE
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