Research Article En Bloc Pancreaticoduodenectomy for Locally Advanced Right Colon Cancers Cihan ALalar, Aras Emre Canda, Tarkan Unek, and Selman Sokmen Department of General Surgery, Dokuz Eyl¨ ul University School of Medicine, ˙ Izmir, Turkey Correspondence should be addressed to Cihan A˘ galar; cihan.agalar@deu.edu.tr Received 30 January 2017; Accepted 4 June 2017; Published 2 July 2017 Academic Editor: Michael H¨ unerbein Copyright © 2017 Cihan A˘ galar et al. Tis is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Locally advanced right colon cancer may invade adjacent tissue and organs. Direct invasion of the duodenum and pancreas necessitates an en bloc resection. Previously, this challenging procedure was associated with high morbidity and mortality; however, today, this procedure can be done more safely in experienced centers. Te aim of this study is to report our experience on en bloc right colectomy with pancreaticoduodenectomy for locally advanced right colon cancers. Between 2000 and 2012, 5 patients underwent en bloc multivisceral resection. No major morbidities or perioperative mortalities were observed. Median disease-free survival time was 24.5 months and median overall survival time was 42.1 (range: 4.5–70.4) months in our series. One patient lived 70 months afer multivisceral resection and underwent cytoreductive surgery and total pelvic exenteration during the follow-up period. In locally advanced right colon tumors, all adhesions should be considered as malign invasion and separation should not be done. Te reasonable option for this patient is to perform en bloc pancreaticoduodenectomy and right colectomy. Tis procedure may result in long-term survival with acceptable morbidity and mortality rates. Multidisciplinary teamwork and multimodality treatment alternatives may improve the results. 1. Introduction Te reported rate of adjacent organ invasion in colorectal cancer is 5.5–16.7% [1, 2]. Compared to other locations, lef colonic and rectosigmoid tumors have a higher locally inva- sive potential [3, 4]. Although tumors located in the right colon have a less invasive potential, surrounding tissue or organ invasion such as duodenum, pancreas, liver, gall blad- der, right kidney, and adrenal gland was reported. In locally advanced tumors, it is hard to diferentiate neoplastic inva- sion from infammatory adhesions intraoperatively. Direct invasion of the duodenum and pancreas may cause surgical difculties which necessitate an en bloc resection and may discourage the surgeon. Only few series were published on en bloc multivisceral resection with pancreaticoduodenectomy (PD) for right colon cancers. Previously, this challenging procedure was associated with high morbidity and mortality; however, today, this procedure can be done more safely in experienced centers [5, 6]. Te aim of this study is to report our experience on en bloc right colectomy (RC) with PD for locally advanced right colon cancers (LARCC). 2. Materials and Methods Between 2000 and 2012, patients who underwent en bloc multivisceral resection (RC and PD) for primary LARCC and had a complete follow-up were included. Patients with primary or recurrent pancreas and duodenum tumors and recurrent colon cancers and those who had peritoneal car- cinomatosis or distant metastasis were excluded. When the primary LARCC was adherent to the duodenum and pan- creas, we performed en bloc multivisceral resection including RC and PD to achieve clear margins. Patient demograph- ics, presenting symptoms, operation data, histopathological results (tumor diameter, histopathological type and diferen- tiation, depth of invasion, lymph node status, and surgical margins), perioperative morbidity and mortality, and onco- logical follow-up data were analyzed retrospectively from a prospectively collected database. In our institution, we discuss and plan treatment of all patients having colorectal malignancy both pre- and post- operatively in multidisciplinary team meetings. We follow up our patients by using the American Society of Colon Hindawi International Journal of Surgical Oncology Volume 2017, Article ID 5179686, 5 pages https://doi.org/10.1155/2017/5179686