title: Combined right hemicolectomy and pancreaticoduodenectomy for locally advanced right hemicolon cancer.
abstract: Extracolonic invasion of the duodenum and/or pancreatic head rarely occurs in patients with right hemicolon cancer. However, when necessary, combined radical operation is a challenge to the surgeon. We reported 7 patients with locally advanced right hemicolon cancer who underwent combined right hemicolectomy (RH) and pancreaticoduodenectomy (PD) due to direct involvement of the duodenum or pancreatic head. This study included four males and three females with a mean age of 66.9+/-5.9 years. Computed tomography (CT) scans revealed right hemicolon cancer with duodenal invasion (5 patients) and pancreatic invasion (2). The mean operation time was 410+/-64 minutes and the estimated blood loss was 514+/-157 mL. After the operation, the mean postoperative hospital stay was 22.1+/-7.2 days. Five patients had postoperative complications. The mean follow-up time was 16.4+/-5.9 months. During this period, three patients died from tumor recurrence, one from postoperative complications, one from pulmonary disease, and two survived until the last scheduled follow-up. Five patients survived more than one year. Combined RH and PD for locally advanced right hemicolon cancer can be performed safely, thus providing a long-term survival rate in selected patients in a high-volume center.
authors.affiliation: Department of Colorectal and Anal Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China. cwbin@hotmail.com).
authors.forename: Qin-Song
authors.initials: QS
authors.lastname: Sheng
authors.forename: Wen-Bin
authors.initials: WB
authors.lastname: Chen
authors.forename: Min-Jiang
authors.initials: MJ
authors.lastname: Li
authors.forename: Xiao-Bin
authors.initials: XB
authors.lastname: Cheng
authors.forename: Wei-Bing
authors.initials: WB
authors.lastname: Wang
authors.forename: Jian-Jiang
authors.initials: JJ
authors.lastname: Lin
mesh_terms: D000368:Aged; D016063:Blood Loss, Surgical; D003082:Colectomy / Q000009:adverse effects / Q000401:mortality; D003110:Colonic Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D004386:Duodenum / Q000473:pathology / Q000601:surgery*; D005260:Female; D061847:Hospitals, High-Volume; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local; D061646:Operative Time; D010179:Pancreas / Q000473:pathology / Q000601:surgery*; D016577:Pancreaticoduodenectomy / Q000009:adverse effects / Q000401:mortality; D011183:Postoperative Complications / Q000209:etiology; D012307:Risk Factors; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome