38: Intestinal Autotransplantation for Locally Advanced or Recurrent Right Colon Cancer Invading the Superior Mesenteric Artery

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Introduction: Involvement of the superior mesenteric artery (SMA) by locally advanced or recurrent colon cancer is considered inoperable, associated with a dismal prognosis. Attempted resection may lead to uncontrolled massive bleeding, irreversible intestinal ischemic damage, or a noncurative resection (R1 or R2). This study aimed to examine outcomes of intestinal autotransplantation (IATx) alone or IATx plus pancreaticoduodenectomy in patients with right colon cancer invading SMA. Methods: This retrospective cohort study included patients undergoing IATx between May 1999 and December 2021 in intestinal transplant programs in two university-affiliated hospitals in China. Results: A total of ten patients underwent IATx combined with pancreaticoduodenectomy (n=8) or IATx alone (n=2). Eight (80%) were male, and the median age were 55 years (range, 32-71 years). Kaplan-Meier estimates for recurrence-free and overall survival at 3 years after IATx were 80% and 100%, respectively. Postoperatively, 3 patients experienced no complications, whereas 7 experienced Clavien-Dindo complications of grade II (3), grade IIIA (2), and grade IIIB (2) including acute venous thrombosis, upper gastrointestinal bleeding, pleural effusions, and gastropareses. Conclusions: This study’s findings of recurrence-free and overall survival rates suggest that select patients with unresectable, locally advanced or recurrent colon cancer may benefit from IATx.

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