8 Cancers of the right colon was defined as located in the cecum, ascending colon, or hepatic flexure. The standard lymph node dissection included removal of the epicolic, paracolic, intermediate, and main lymph nodes, corresponding to D3-level lymph node dissection according to the General Rules for Clinical and Pathological Studies on Cancer of the Colon, Rectum, and Anus in Japan. The subjects were 215 Japanese patients (127 men and 88 women) who underwent right (hemi) colectomy with standard lymph node dissection for right colon cancer through a conventional open or minilaparotomy approach 5– 7 at our hospital between January 1999 and September 2009. These data would be useful to safely perform lymph node dissection around the SMV. The arterial branches toward the hepatic flexure crossed the SMV ventrally in 151 eligible cases: the branch originated from the common trunk of the middle colic artery in 97 patients (64.2%) and 1 and 2 arteries directly originated from the SMA in 49 patients (32.5%) and in 5 patients (3.3%), respectively. When the RCA was present, both the ICA and the RCA crossed the SMV ventrally in 44 patients (20.5%), dorsally in 10 patients (4.7%), the RCA crossed the SMV ventrally and the ICA dorsally in 10 patients (4.7%), and the RCA crossed the SMV dorsally and the ICA ventrally in 5 patients (2.2%). The right colic artery (RCA) was absent in 146 patients (67.9%), with the ileocolic artery (ICA) crossing the superior mesenteric vein (SMV) ventrally in 78 patients (36.3%). Chin J Gastrointest Surg (Chinese), 2004, 7: 35–37.We analyzed data on the three-dimensional vascular anatomy of the right colon from the operative documents of 215 patients undergoing oncologic resection for right colon cancer. En bloc pancreaticoduodenectomy for right colon carcinoma invading adjacent organs. En bloc resection of right-sided colonic adenocarcinoma with adjacent organ invasion. En bloc pancreaticoduodenectomy for right colon cancer invading adjacent organs. Surg Gynecol Obstet, 1953, 97: 177–182.īerrospi F, Celis J, Ruiz E, et al. Multiple organ resection for advanced carcinoma of the colon and rectum. Management of patients with carcinoma of the right colon invading the duodenum or pancreatic head. Long-term survival in patients with locally advanced colon cancer after en bloc pancreaticoduodenectomy and colectomy. Combined resection of the duodenum and pancreas for locally advanced colon cancer. The surgical selection and evaluation of the surgical treatment of superior mesenteric artery syndrome. Pedicled ileal flap to repair large duodenal defect after right hemicolectomy for right colon cancer invading the duodenum. Ishiguro S, Moriura S, Kobayashi I, et al. Surgical treatment of cancer of hepatic flexure of colon invading the duodenum. The surgical procedure to be performed is usually decided according to the cancer location, extent, and duodenal defect and invasion, which are important for prolonging life time, improving of quality of life and prognosis in these patients. The total 3- and 5-year survival rates after surgery were 53.8% and 9.2%, respectively. Other patients were cured without postoperative complications. One patient with anastomotic leakage healed within 3 weeks. Ten cases underwent duodenal diverticularization. Four patients underwent pancreaticoduodenectomy combined with right hemicolectomy for colon cancer involving the pancreatic head. Conservative resection of right-sided colon was performed in 18 patients with wide invasion. Dudenojejunostomy was used to reconstruct the large defect measuring more than 5 cm in 3 patients. Pedicled ileal flap was used to cover the large duodenal defect measuring 2.0–3.0 cm in 5 patients. The 25 patients with local invasion underwent en bloc resection of the duodenal wall. All the cases were divided into three types (local invasion, regional invasion, and cancer with internal fistula) according to duodenal defect, including local invasion ( 2.0 cm) and the presence of internal fistula. Their clinicopathological data were retrospectively reviewed and analyzed. The 65 patients with right colon carcinoma of hepatic flexure invading the duodenum, treated in our department from 1987 to 2007, were included in this study. The aim of the study was to discuss surgical treatment of right colon carcinoma of hepatic flexure invading the duodenum.
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