Duodenal seromyectomy in the management of adherent colonic carcinoma in elderly patients.
OBJECTIVE
To determine if partial denudation of the duodenum by seromyectomy can achieve tumour clearance in elderly patients with adherent primary colonic carcinoma.


METHODS
A case series.


METHODS
An urban tertiary care centre.


METHODS
Seven elderly patients with Dukes' class C primary adenocarcinoma of the ascending colon adherent to the duodenum but without distant metastases. The follow-up ranged from 29 to 41 months.


METHODS
Right hemicolectomy and seromyectomy of the duodenum at the site of adhesion.


METHODS
Patient survival and tumour recurrence.


RESULTS
One patient died 29 months postoperatively of myocardial infarction but without tumour recurrence. Another patient had a solitary metastasis in the right liver lobe 7 months postoperatively. She was disease free 34 months after a right hemihepatectomy. The other 5 patients were alive and disease free at their last follow-up.


CONCLUSIONS
Duodenal seromyectomy with postoperative chemotherapy for locally advanced adherent colonic cancer seems to be an acceptable management strategy for elderly patients in whom major en bloc resections present a greater than average risk of death.
Sharma
P
P
Department of Surgery, State Hospital, Kristiansund, Norway.
Klaasen
H
H
D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D000368:Aged; D003082:Colectomy; D003110:Colonic Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D004386:Duodenum / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local; D015996:Survival Rate