LAPAROSCOPIC RIGHT HEMICOLECTOMY COMBINED WITH PARTIAL DUODENAL RESECTION FOR THE TREATMENT OF ASCENDING COLON ADENOCARCINOMA

Introduction Ascending colon tumors, when locally advanced, may invade adjacent vital structures, posing a challenge for oncologically adequate resection. For an adequate margin, it is often necessary to resect contiguous organs, and performing this by minimally invasive techniques can be complex.

Objectives Surgical description of oncological right hemicolectomy where the tumor was pinching the duodenum, requiring partial enterectomy for R0 resection.

Methods A 64-year-old patient presented with severe abdominal pain and significant weight loss. A colonoscopy revealed a stenosing and infiltrative lesion, likely in the ascending colon, with an adenocarcinoma diagnosis. Staging images confirmed a tumor in the ascending colon and multiple lesions suggestive of liver metastases. Due to obstructive symptoms, a minimally invasive approach to the colon was chosen. During the cavity exploration, a large tumor was identified, pinching the duodenum in its third portion. It was decided to proceed with the standard dissection until isolating the area of duodenal invasion and perform tangential stapling of the duodenum to release the specimen with adequate oncological margins.

Results Partial duodenal enterectomy with the assistance of an endostapler proved to be an effective alternative for a surgery with clear margins, allowing the patient to recover quickly and continue with oncological treatment.

Conclusion Tangential invasion of adjacent structures can be managed by minimally invasive techniques with good oncological outcomes and no adverse effects on the patient’s recovery.

Publication History

Article published online:
25 April 2025