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International Journal of Surgical Oncology
Volume 2017, Article ID 5179686, 5 pages
https://doi.org/10.1155/2017/5179686
Research Article

En Bloc Pancreaticoduodenectomy for Locally Advanced Right Colon Cancers

Department of General Surgery, Dokuz Eylül University School of Medicine, İzmir, Turkey

Correspondence should be addressed to Cihan A─čalar; rt.ude.ued@ralaga.nahic

Received 30 January 2017; Accepted 4 June 2017; Published 2 July 2017

Academic Editor: Michael Hünerbein

Copyright © 2017 Cihan Ağalar et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Locally advanced right colon cancer may invade adjacent tissue and organs. Direct invasion of the duodenum and pancreas necessitates an en bloc resection. Previously, this challenging procedure was associated with high morbidity and mortality; however, today, this procedure can be done more safely in experienced centers. The aim of this study is to report our experience on en bloc right colectomy with pancreaticoduodenectomy for locally advanced right colon cancers. Between 2000 and 2012, 5 patients underwent en bloc multivisceral resection. No major morbidities or perioperative mortalities were observed. Median disease-free survival time was 24.5 months and median overall survival time was 42.1 (range: 4.5–70.4) months in our series. One patient lived 70 months after multivisceral resection and underwent cytoreductive surgery and total pelvic exenteration during the follow-up period. In locally advanced right colon tumors, all adhesions should be considered as malign invasion and separation should not be done. The reasonable option for this patient is to perform en bloc pancreaticoduodenectomy and right colectomy. This procedure may result in long-term survival with acceptable morbidity and mortality rates. Multidisciplinary teamwork and multimodality treatment alternatives may improve the results.