Keywords:
colon cancer; multivisceral resection; pancreatic resection
Abstract
Objective. To disseminate own experience of surgical treatment of locally-extended colonic cancer with pancreatic spreading.
Маterials and methods. Results of surgical treatment of 24 patients (in 2004 – 2015 yrs), suffering locally-extended colonic cancer with pancreatic spreading, were studied. There were 8 (33%) men and 16 (67%) women. Average age of the patients have constituted (65.2 ± 11.2) yrs old. Colonic cancer, besides pancreatic gland, have spreaded into paranephral cellular tissue – in 6 (25%) patients, spleen – in 5 (20.8%), duodenum – in 3 (12,5%), stomach – in 1 (4.1%), small bowel – in 1 (4.1%), abdominal wall – in 1 (4.1%). The patients were divided into two groups. Of the patients of Group І in 13 (54.1%) symptomatic operative interventions were performed and in 11 (45.8%) of those of the Group ІІ - radical.
Results. The patients’ survival after symptomatic operative interventions have constituted (5.1 ± 3) mo. In 3 (23.0%) patients morbidity was absent. Postoperative complications (in accordance to Clavien-Dindo classification) of the Degree І were revealed in 5 (38,4%) patients, ІІ – in 2 (15.3%), ІVа – in 1 (7.6%), and V – in 2 (15.3%). Early postoperative lethality was caused by the V Degree morbidity: profuse gastro-intestinal hemorrhage – in 1 (7.6%) and pulmonary thromboembolism - in 1 (7.6%).
The survival of patients after radical operative interventions have constituted (19.5 ± 14) mo. There were performed following operative interventions: distal pancreatic resection – in 10 (91%) patients, pancreaticoduodenal resection - in 1 (9%). In 3 (27.2%) patients postoperative complications were not revealed. Postoperative complications (in accordance to Clavien-Dindo classification) of the Degree I were detected in 3 (27.2%) patients, ІІІа – in 1 (9%), ІVа – in 1 (9%), and V – in 2 (18.1%). Because of severe purulent-septic complications 2 (18.1%) patients died.
Conclusion. In colonic cancer with pancreatic spread, in the absence of remote metastases, low index of comorbidity by Charlson Comorbidity Index (ССІ) and estimation in accordance to the ECOG scale lesser then 2 points it is recommended to perform multivisceral resection, including pancreatic resection.
Author Biographies
V. V. Kеrnychnyi, Vinnytsya National Medical University named after М. І. Pyrogov; Khmelnytskyi Regional Hospital
Vitalii V. Kernychnyi, PhD, assistant professor,
assistant professor Department of Surgery, Faculty of Postgraduate Education,
Vinnytsya National Pirogov Memorial Medical University,
Address: 1 Pilotska Str., 29000, Khmelnitskiy, Ukraine,
tel.: +38 (382) 65-83-35;
E-mail: kernychniy.vv@gmail.com
ORCID: http://orcid.org/0000-0002-5283-6358
A. I. Sukhodolia, Vinnytsya National Medical University named after М. І. Pyrogov; Khmelnytskyi Regional Hospital
Anatoliy I. Sukhodolia, MD, PhD, prof.,
professor Department of Surgery, Faculty of Postgraduate Education,
Vinnytsya National Pirogov Memorial Medical University,
Address: 1 Pilotska Str., 29000, Khmelnitskiy, Ukraine,
tel.: +38 (382) 79-42-26;
E-mail: sukhodolia.ai@gmail.com
ORCID: https://orcid.org/0000-0002-3509-3070
V. M. Monastyrskyi, Vinnytsya National Medical University named after М. І. Pyrogov; Khmelnytskyi Regional Hospital
Volodymyr M. Monastyrskyi, PhD, associate professor Department of Surgery, Faculty of Postgraduate Education,
Vinnytsya National Pirogov Memorial Medical University,
Address: 1 Pilotska Str., 29000, Khmelnitskiy, Ukraine,
tel.: +38 (382) 65-83-35;
E-mail: vova.monastirskiy@gmail.com
ORCID: http://orcid.org/0000-0002-7178-9569
V. A. Moroz, Vinnytsya National Medical University named after М. І. Pyrogov; Khmelnytskyi Regional Oncological Dispenser
Viacheslav A.Moroz, PhD, assistant professor,
assistant professor Department of Surgery, Faculty of Postgraduate Education,
Vinnytsya National Pirogov Memorial Medical University,
Address: 1 Pilotska Str., 29000, Khmelnitskiy, Ukraine,
tel.: +38 (382) 65-40-74;
E-mail: doktorfrost@ukr.net
ORCID: http://orcid.org/0000-0002-9177-126X
V. V. Balytskyi, Vinnytsya National Medical University named after М. І. Pyrogov; Khmelnytskyi Regional Hospital
Vitalii V. Balytskyi, PhD, assistant professor,
assistant professor Department of Surgery, Faculty of Postgraduate Education,
Vinnytsya National Pirogov Memorial Medical University,
Address: 1 Pilotska Str., 29000, Khmelnitskiy, Ukraine,
tel.: +38 (382) 65-13-17;
E-mail: v.balytskyy@ukr.net
ORCID: http://orcid.org/0000-0003-1076-5237
O. O. Pidmurniak, Vinnytsya National Medical University named after М. І. Pyrogov; Khmelnytskyi Regional Hospital
Oleksandr O. Pidmurniak, MD, PhD, assistant professor,
assistant professor Department of Surgery, Faculty of Postgraduate Education,
Vinnytsya National Pirogov Memorial Medical University,
Address: 1 Pilotska Str., 29000, Khmelnitskiy, Ukraine,
tel.: +38 (382) 65-64-34;
E-mail: ant-70@ukr.net
ORCID: http://orcid.org/0000-0002-9107-2549
References
1. Won-Suk L, Woo Yong L, Ho-Kyung C, Seong-Ho C. En bloc resection for right colon cancer directly invading duodenum or pancreatic head. Yonsei Med J. 2009 Dec;50(6):803-6.
2. Sara JT, Peter TWK, Pablo ES, Daniel K, Sean PC, Carol-Anne M, et al. Combined pancreaticoduodenectomy and colon resection for locally advancen peri-ampullary tumours: analysis of peri-operative morbidity and mortality. HPB. 2014 Sep;16(9):797-0.
3. Whipple A. The rationale of radical surgery for cancer of the pancreas and ampullary region. Ann Surg. 1941 Oct;114(4):612-5.
4. Wen-Chi C, Keng-Hong L, Chang-Hsien L, Yu-Shin H, Miao-Fen C, Yu-fan C, et al. To Operate or not: Prediction of 3-month postoperative mortality in geriatric cancer patients. J Cancer. 2016;(7)1:14-21.
How to Cite
KеrnychnyiV. V., Sukhodolia, A. I., Monastyrskyi, V. M., Moroz, V. A., Balytskyi, V. V., & Pidmurniak, O. O. (2018). Results of surgical treatment of locally-spread colon cancer with pancreatic spread. Klinicheskaia Khirurgiia, 85(8), 65-67. https://doi.org/10.26779/2522-1396.2018.08.65
Section
General Problems of Surgery
