‘Curative’ surgery in carcinoma of the colon involving duodenum. A report of 6 cases

Abstract

iliac fossa. Laparotomy revealed a carcinoma of the transverse colon with a pericolic abscess. A caecostomy was Performed-In November, 1966, a further 1aParotomY was carried out with drainage of an abdominal wall abscess. Biopsy showed an adenocarcinoma and the lesion was considered inoperable.The patient was transferred to the Westminster Hospital for consideration of radiotherapy or cytotoxic therapy. On admission he was thin and anaemic (haemo-INVASION of adjacent structures by a neoplasm is globin 12.7 g.). Faeces were discharging through the frequently s~o n Y m o u s with inoperability. The caecostomy and there was a palpable mass in the right common situation where this general rule meets with iliac fossa. This mass was adherent to the laparotomy

Malignant Coloduodenal Fistulas-Review of Literature and Case Report

“…Ellis used a jejunal loop to close the duodenal wall defect. (30) Definitive surgery involves resection of the tumor and the fistula en-block. Colectomy with partial duodenectomy and primary duodenal closure of the duodenal defect has been reported with minimal duodenal involvement [30,31].…”

“…(30) Definitive surgery involves resection of the tumor and the fistula en-block. Colectomy with partial duodenectomy and primary duodenal closure of the duodenal defect has been reported with minimal duodenal involvement [30,31]. Highest survival rates have been reported when Colectomy is combined with pancreatico -duodenectomy (Whipple's Procedure) due to resection of the tumor and the fistula as well as adequate regional lymph node dissection [28].…”

En bloc pancreaticoduodenectomy for right colon cancer invading adjacent organs*

“…The surgeon must establish the magnitude of involvement of the invaded organs and the amount of tissue necessary to encompass the tumor with free margins. In selected cases where the in®ltration is limited to the duodenum it is feasible to perform en bloc local resection of the duodenal wall avoiding a major procedure without affecting long-term survival [11,12,15,16]. For larger tumors invading the duodenum and/or the pancreas head a combined PD and colectomy will be needed [11±13].…”

Malignant Duodenocolic Fistula

“…The mor tality rate within 30 days was 28% [3], This high mortal ity rate is mainly related to peritonitis following leakage from the duodenum. Closure of the duodenal defect seems to be difficult [2,5], 10 patients died within a year. The longest period of survival reported for this operation was 6 years [3].…”