Results of surgical treatment of locally-spread colon cancer with pancreatic spread

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

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Published
2018-08-30
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