結腸癌合併切除例の検討

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A clinicopathological study was done on the cases which reqired an extensive resection for colon cancer. Of 783 cases of curatively resected solitary colon cancer, 90 (11.5 %) had the necessity of combining resection of adjacent organs. As to the site of primary tumor in these cases, the right side colon, especially hepatic flexure, required a combined resection at a high frequency. In the cases of which tumor was larger than 5.1 cm, circular and mucinous carcinoma were frequently encountered than other types of carcinoma. Small intestine, abdominal wall and urinary bladder were of most frequentry resected organs. 36 cases (40 %) showed microscopic tumor invasion to adjacent organs with 72 % coincidence rate with the gloss diagnosis. The five year survival rate in all cases was 64.5 % and that in microscopic invasion cases was 62.5 %, and 4 out of 7 pancreatduodenectomized cases survived over five years. In addition, peritoneal and local cancer recurrence were observed in more than half of the recurrent cases. In the cases of resected small intestine, 3 cases in which tumors deeply invaded to the mocosa of the small intestine, had a secondary lymphnode metastasis in the mesenterium of the small intestine. In conclusion, it is difficult to macroscopically diagnose malignant invasion in these cases, but if the cancer invasin is suspected, agrressive combined resection of adjacent organ and its surrounding lymphnodes is necessary to make a curative resection.
日本大腸肛門病学会の論文

結腸癌合併切除例の検討

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