Right hemicolectomy plus pancreaticoduodenectomy vs partial duodenectomy in treatment of locally advanced right colon cancer invading pancreas and/or only duodenum |
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| Institution: | 1. Department of Digestive and Liver Surgery Unit, St Maria Hospital, Terni, Italy;2. Pancreatic Surgery Unit, Università Politecnica delle Marche, Ancona, Italy;3. Department of General and Oncologic Surgery, University of Perugia, Perugia, Italy;1. College of Information Science and Engineering, Key Laboratory for Micro/Nato Optoelectronic Devices of Ministry of Education, Hunan University, Changsha 410082, China;2. College of Mechanical and Vehicle Engineer, Hunan University, Changsha 410082, China;1. Department of Physics, University of Kerala, Trivandrum, India;2. Space Physics Laboratory, Vikram Sarabhai Space Centre, ISRO, Trivandrum, India;1. Xijing Hospital of Digestive Diseases, the Fourth Military Medical University, Xi''an, China;2. Department of Pathology, Xijing Hospital, the Fourth Military Medical University, Xi''an, China;3. Department of Clinical Pharmacology, Xijing Hospital, the Fourth Military Medical University, Xi''an, China;1. Jones Graduate School of Business – MS 531, Rice University, 6100 Main Street, Houston, TX 77005, United States;2. University of Piraeus, Department of Banking and Financial Management, 80 Karaoli & Dimitriou, Piraeus 18534, Greece |
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| Abstract: | IntroductionPancreatic or duodenal invasion by locally advanced right colon cancer is an unusual event whose management still represents a surgical challenge. This review aims to compare results of limited vs. extended resection in case of primary right colon cancer invading pancreas and/or duodenum.MethodsA systematic search in Medline, Embase and Cochrane Central Register of Controlled Trials (CENTRAL) was performed. All trials describing the surgical treatment of right colon cancer invading pancreas and/or duodenum were considered. A data extraction sheet was developed, based on the Cochrane Consumers and Communication Review Group's data extraction template.Results5-years overall survival was 52% after en bloc pancreaticoduodenectomy plus right hemicolectomy vs. 0 and 25% in case of duodenal resection with correction by direct suture or pedicled ileal flap, respectively. 30-day postoperative morbidity rate was slightly higher after en block resections (12.8%) with respect to duodenal local resection and direct suture or pedicled ileal flap repair (0 and 12.2%, respectively). After extended resection the rate of pancreatico-jejunal anastomotic leakage was 7.7%.ConclusionsIn patients with right colon cancer extended to the pancreas and/or duodenum surgical multivisceral resection is suggested when complete tumour removal (R0) is achievable. Even though no significant differences in postoperative morbidity and mortality have been shown, 5 y OS has improved in extended resections as compared to duodenal local resection with defect repair either by direct suture or by a pedicled ileal flap. |
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| Keywords: | Cancer Colon Duodenum Pancreas Surgery |
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