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作者在近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,比较活动;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。
In the past 10 years, the authors treated 10 cases of right colon cancer invading the duodenum according to different pathological features. The surgical methods included local resection of the duodenum, perforation repair, and extended pancreatoduodenectomy. Nine cases recovered in the first postoperative period and one patient was discharged after treatment of complications. Two cases have survived for more than three years. According to the degree of tumor infiltration of the duodenum, the authors proposed to classify the degree of infiltration into three types: Type I, a small area of cancer infiltrating the duodenum, a diameter within 1.5~2cm, comparison activities; type II, tumor infiltration, twelve fingers Intestine diameter greater than 2cm, the affected part is relatively fixed, the surrounding duodenal tissue can be involved; type III, duodenal tumor perforation. According to clinical classification, the article discusses the corresponding surgical treatment, emphasizing that when the colon cancer invades the duodenum, active surgical treatment will help improve the condition or enable the patient to heal.