Khirurgiia · 2026
[The results of surgical interventions for colon cancer with spread to the organs of the pancreatoduodenal zone].
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Gevorkyan Yu A, Soldatkina N V, Kolesnikov E N, Dashkov A V, Ter-Grigoryants M B, Mironenko I N, Bondarenko O K, Kit O I
Аннотация
OBJECTIVE: The aim of the study - to study the immediate and long-term results of surgical interventions for colon cancer with spread to the organs of the pancreatic duodenal zone.
RESEARCH METHODS: A retrospective analysis of 38 cases of treatment of malignant tumors of the colon involving the pancreatoduodenal zone in the Federal State Budgetary Institution "NMIC of Oncology" of the Ministry of Health of the Russian Federation from 2013 to 2024 was carried out. All patients underwent combined surgical procedures, including right- or left-sided hemicolectomy with duodenal resection (34.2%), atypical or distal pancreatic resection (26.3%), corporocaudal pancreatic resection (21.1%), pancreatoduodenal resection (18.4%).
RESULTS: The average volume of intraoperative blood loss was 300 ml, and the average duration of surgery was 280 minutes. The greatest volume of intraoperative blood loss and duration of surgery were observed in combined hemicolectomy with corporocaudal resection of the pancreas. Postoperative complications developed in 15 out of 38 patients (39.5%). Postoperative pancreatitis (13.2%), pancreatic necrosis, external pancreatic fistula and intra-abdominal bleeding (5.3% each) and repeated surgical interventions prevailed 4 (10.5%) patients were treated (ileotransverzoanastomosis failure, small intestine perforation, intra-abdominal bleeding, pancreatic necrosis). Two cases resulted in death in the early postoperative period (5.3%). To date, 15 out of 38 patients (39.5%) are alive, 23 (60.5%) patients have died. The 75%, 50%, and 25% survival rates of the subgroup of patients with duodenal resection were 4.5, 22.5, and 45.3 months, respectively.
CONCLUSION: Surgical interventions for colon cancer with spread to the organs of the pancreatoduodenal zone are technically complex surgical interventions, with a frequency of postoperative complications and a postoperative mortality rate above the average for colon cancer. Nevertheless, in combination with chemotherapy, they can achieve good long-term treatment results.
RESEARCH METHODS: A retrospective analysis of 38 cases of treatment of malignant tumors of the colon involving the pancreatoduodenal zone in the Federal State Budgetary Institution "NMIC of Oncology" of the Ministry of Health of the Russian Federation from 2013 to 2024 was carried out. All patients underwent combined surgical procedures, including right- or left-sided hemicolectomy with duodenal resection (34.2%), atypical or distal pancreatic resection (26.3%), corporocaudal pancreatic resection (21.1%), pancreatoduodenal resection (18.4%).
RESULTS: The average volume of intraoperative blood loss was 300 ml, and the average duration of surgery was 280 minutes. The greatest volume of intraoperative blood loss and duration of surgery were observed in combined hemicolectomy with corporocaudal resection of the pancreas. Postoperative complications developed in 15 out of 38 patients (39.5%). Postoperative pancreatitis (13.2%), pancreatic necrosis, external pancreatic fistula and intra-abdominal bleeding (5.3% each) and repeated surgical interventions prevailed 4 (10.5%) patients were treated (ileotransverzoanastomosis failure, small intestine perforation, intra-abdominal bleeding, pancreatic necrosis). Two cases resulted in death in the early postoperative period (5.3%). To date, 15 out of 38 patients (39.5%) are alive, 23 (60.5%) patients have died. The 75%, 50%, and 25% survival rates of the subgroup of patients with duodenal resection were 4.5, 22.5, and 45.3 months, respectively.
CONCLUSION: Surgical interventions for colon cancer with spread to the organs of the pancreatoduodenal zone are technically complex surgical interventions, with a frequency of postoperative complications and a postoperative mortality rate above the average for colon cancer. Nevertheless, in combination with chemotherapy, they can achieve good long-term treatment results.