Thirty-Day Outcomes in Patients Treated with En Bloc Colectomy and Pancreatectomy for Locally Advanced Carcinoma of the Colon

Paquette, Ian M.; Swenson, Brian R.; Kwaan, Mary R.; Mellgren, Anders; Madoff, Robert D.

doi:10.1007/s11605-011-1691-7

Cited by 23 publications

(27 citation statements)

References 16 publications

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“…In standard RC + PPD, the surgeon should do five anastomoses: Wirsungojejunostomy (WJ) or Wirsungogastrostomy (WG), choledochojejunostomy (CJ), gastrojejunostomy, ileotransversostomy, and jejunojejunostomy. Reported anastomotic leakage ratio is 0–33% for any anastomosis in this procedure [22]. In our series, anastomotic leakage did not occur in any patient.…”

Section: Discussionsupporting

confidence: 45%

“…When the surgeon confronts a LARCC during the operation, all adhesions to the tumor should be considered as malign invasion, since adhesions were reported as 33–84% malignant on pathologic examination [6, 12]. Separation should not be done, because separation of adhesions is associated with high (70–100%) local recurrence rates [6, 17, 20–22]. The nature of the adherence between the primary and adjacent viscera should be determined only upon histologic assessment of the extended resection specimen.…”

Section: Discussionmentioning

confidence: 99%

“…This collaboration may explain the zero anastomotic leakage ratio in our series. The reported mortality rate between 0 and 30 days after en bloc pancreas and colon resection is 6.3% [22]. There was no statistically significant difference in perioperative death between only PPD, only RC, and RC + PPD [22].…”

Section: Discussionmentioning

confidence: 99%

“…General suggestion for the patients with comorbidities is to choose partial duodenectomy option if the papilla of Vater is free from invasive disease instead of major surgery [17, 25]. However, this procedure may result in a higher local recurrence rate [22]. In our series, Case #3 deserves to get more attention since it has interesting features such as long-term survival after en bloc RC + PPD despite the high risk of the operation (ASA score was 3).…”

Section: Discussionmentioning

confidence: 99%

“…In the literature, it was published that 8 patients underwent R0 en bloc colectomy and PD for locally advanced colon carcinoma and survived nearly or more than ten years (Saiura et al, five patients [6]; Praderi et al, two patients [34]; and Berrospi et al, one patient [23]). The reported 5-year survival after R0, en bloc RC + PD, is 52% [35]; on the other hand, 5-year survival is 0−23% [3, 20, 22, 36] in patients who underwent surgery by separation of adhesions to adjacent organs. Median survival was 42 months in our series; in one extreme case that had two recurrences after RC and PD, she underwent major surgeries for local recurrences (pelvic exenteration and CRS and HIPEC).…”

Section: Discussionmentioning

confidence: 99%

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En Bloc Pancreaticoduodenectomy for Locally Advanced Right Colon Cancers

Ağalar

Canda

Ünek

et al. 2017

International Journal of Surgical Oncology

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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.

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Section: Discussionsupporting

confidence: 45%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

En Bloc Pancreaticoduodenectomy for Locally Advanced Right Colon Cancers

Ağalar

Canda

Ünek

et al. 2017

International Journal of Surgical Oncology

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Morbidity of colectomy during pancreatoduodenectomy: An analysis of the pancreas‐targeted American College of Surgeons National Surgical Quality Improvement Program Registry

Harris

Osborn

Bennett

et al. 2022

J Hepato Biliary Pancreat

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Background Pancreatoduodenectomy is a complex operation with considerable morbidity and mortality. Locally advanced tumors may require concurrent colectomy. We hypothesized that a concurrent colectomy increases the risk associated with pancreatoduodenectomy. Methods This retrospective review of the 2014–2019 pancreas‐targeted American College of Surgeons National Surgical Quality Improvement Program registry classified operations as pancreatoduodenectomy (PD) versus pancreatoduodenectomy/colectomy (PD+C). The two groups were compared with respect to demographics, comorbidities, disease characteristics, intraoperative variables, and postoperative outcomes. Main effect models were developed to examine the effect of concurrent colectomy on outcomes after adjusting for potential confounders. Results Of 24 421 pancreatoduodenectomies, 430 (1.8%) involved concurrent colectomy. PD + C patients had less comorbidities (obesity 19% vs. 27%, hypertension 43% vs. 53%, diabetes 20% vs. 26%) and were associated with malignant diagnosis (94% vs. 83%), vascular resection (28% vs. 18%), and longer operative time (median 6.9 vs. 6 h). On multivariable analysis, concurrent colectomy was independently associated with serious morbidity (adjusted odds ratio [OR] 2.62, 95% confidence interval [CI]: 1.94–3.54) but not mortality (OR 1.44 [0.63–3.31]). Conclusions Concurrent colectomy at the time of pancreatoduodenectomy significantly increased the odds of serious morbidity but did not affect mortality. This should be considered in operative planning, preoperative counseling, and sequencing of cancer‐directed treatments.

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Short‐ and long‐term surgical outcomes of pancreatic resection for retroperitoneal sarcoma: A long‐term single‐center experience of 90 cases

Liu

Wang

et al. 2022

Journal of Surgical Oncology

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Thirty-Day Outcomes in Patients Treated with En Bloc Colectomy and Pancreatectomy for Locally Advanced Carcinoma of the Colon

Abstract: Perioperative outcomes with en bloc pancreatectomy and colectomy include increased pulmonary complications, blood transfusions, wound complications, and length of stay compared to patients treated with colectomy alone for colon cancer.

Cited by 23 publications

References 16 publications

En Bloc Pancreaticoduodenectomy for Locally Advanced Right Colon Cancers

En Bloc Pancreaticoduodenectomy for Locally Advanced Right Colon Cancers

Morbidity of colectomy during pancreatoduodenectomy: An analysis of the pancreas‐targeted American College of Surgeons National Surgical Quality Improvement Program Registry

Short‐ and long‐term surgical outcomes of pancreatic resection for retroperitoneal sarcoma: A long‐term single‐center experience of 90 cases

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