65例患者结肠肝曲癌侵犯十二指肠的外科治疗及预后（英文）.pdfVIP

Chinese-German Journal of Clinical Oncology March 2011, Vol. 10, No. 3, P166–P169 DOI 10.1007/s10330-011-0759-x Surgical treatment and prognosis of cancers of hepatic flexure of colon invading the duodenum in 65 patients Weiliang Yang, Shenglong Li, Lei Zhang, Fujing Wang, Yulin Ma Department of General Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin 150086, China Received: 12 December 2010 / Revised: 20 January 2011 / Accepted: 15 February 2011 © Huazhong University of Science and Technology and Springer-Verlag Berlin Heidelberg 2011 Abstract Objective: The aim of the study was to discuss surgical treatment of right colon carcinoma of hepatic flexure invading the duodenum. Methods: The 65 patients with right colon carcinoma of hepatic flexure invading the duodenum, treated in our department from 1987 to 2007, were included in this study. Their clinicopathological data were retrospectively reviewed and analyzed. All the cases were divided into three types (local invasion, regional invasion, and cancer with internal fistula) according to duodenal defect, including local invasion ( 2.0 cm), wide invasion ( 2.0 cm) and the presence of internal fistula. Results: The 25 patients with local invasion underwent en bloc resection of the duodenal wall. Pedicled ileal flap was used to cover the large duodenal defect measuring 2.0–3.0 cm in 5 patients. Dudenojejunostomy was used to reconstruct the large defect measuring more than 5 cm in 3 patients. Conservative resection of right-sided colon was performed in 18 patients with wide invasion. Four patients underwent pancreaticoduodenectomy combined with right hemicolectomy for colon cancer involving the pancreatic head. Ten cases underwent duodenal diver