右半结肠癌侵犯十二指肠的外科处理  

SURGICAL MANAGEMENT OF DUODENUM INFILTRATED BY RIGHT COLON CARCINOMA

作　　者：周建平[1] 皮执民[1] 范丹凤[1] 胡继雄[1] 钟德玕 庄赞根[1] 王先明[1] 

机构地区：[1]湖南医科大学附属第二医院普外科,长沙410011

出　　处：《大肠肛门病外科杂志》1999年第1期1-3,共3页Journal of Coloproctological Surgery

摘　　要：在近10年中对10例右半结肠癌侵犯十二指肠者根据不同病理特点作了处理,术式包括十二指肠局部切除、穿孔修补、扩大胰十二指肠联合切除等,术后9例一期恢复,1例在处理并发症后也恢复出院。2例已生存3年以上。作者根据肿瘤浸润十二指肠程度,提出将浸润程度分为三型:Ⅰ型,癌肿小范围浸润十二指肠,直径在1.5～2cm以内,较活动;Ⅱ型,肿瘤浸润十二指肠直径大于2cm,受累部分比较固定,十二指肠周围组织可同时受累;Ⅲ型,十二指肠存在肿瘤性穿孔。文中根据临床分型就相应的手术处理进行了探讨,强调在结肠癌侵犯十二指肠时,积极的外科处理将有助于改善病情或使病人得以痊愈。Ten cases with infiltrated duodenum by right colon carcinoma were treated surgically in the past decade, including duodenal partial resection, repairing of rupture and pancreatic-duodenal resection. There was no mortality in perioperative period. Two cases survived more than three years. There were three pathologic types according to duodenal infiltrated extents. Type Ⅰ : diameter of infiltrated duodenum was less than 1. 5 - 2 cm and the focus was more movable. Type Ⅱ : the focus was more than 2 cm and stabilzed; periduodenal tissues were sometimes affected. Type I : there was rupture on the focus. It is emphasized that active surgical management of decodenal infiltrated focus should be contributive to improvement of prognosis.

关 键 词：右半结肠癌 穿孔 十二指肠转移瘤 

分 类 号：R735.310.5[医药卫生—肿瘤] R735.350.6[医药卫生—临床医学]