RT Journal Article
SR Electronic
T1 Duodenal seromyectomy in the management of adherent colonic carcinoma in elderly patients
JF Canadian Journal of Surgery
JO CAN J SURG
FD Canadian Medical Association
SP 289
OP 293
VO 40
IS 4
A1 Sharma, Peeyush
A1 Klaasen, Herman
YR 1997
UL http://canjsurg.ca/content/40/4/289.abstract
AB Objective: To determine if partial denudation of the duodenum by seromyectomy can achieve tumour clearance in elderly patients with adherent primary colonic carcinoma.Design: A case series.Setting: An urban tertiary care centre.Patients: Seven elderly patients with Dukes’ class C primary adenocarcinoma of the ascending colon adherent to the duodenum but without distant metastases. The follow-up ranged from 29 to 41 months.Interventions: Right hemicolectomy and seromyectomy of the duodenum at the site of adhesion.Main outcome measures: Patient survival and tumour recurrence.Results: One patient died 29 months postoperatively of myocardial infarction but without tumour recurrence. Another patient had a solitary metastasis in the right liver lobe 7 months postoperatively. She was disease free 34 months after a right hemihepatectomy. The other 5 patients were alive and disease free at their last follow-up.Conclusion: Duodenal seromyectomy with postoperative chemotherapy for locally advanced adherent colonic cancer seems to be an acceptable management strategy for elderly patients in whom major en bloc resections present a greater than average risk of death.