结肠癌合并急性梗阻的个性化处理  

Individualized management of colon cancer complicated with acute obstruction

作　　者：关国欣[1] 罗福文[1] Guoxin Guan;Fuwen Luo(epartment of Acute Abdomen Surgery,the Second Affiliated Hospital of Dalian Medical University,Dalian 116027,China)

机构地区：[1]大连医科大学附属第二医院急腹症外科,116027

出　　处：《中华结直肠疾病电子杂志》2024年第6期459-463,共5页Chinese Journal of Colorectal Diseases(Electronic Edition)

摘　　要：结肠癌合并梗阻是临床较为常见的急腹症。患者多高龄、合并基础疾病、临床分期较晚,围手术期并发症的发生率及死亡率均较高,因此处理起来非常棘手。目前已经获知的处理措施有造瘘术、肿瘤根治切除一期吻合术、支架或肠梗阻导管等腔内治疗、经典Hartmann手术或三期手术等。但每一种处理手段都有其优劣性,同时还需要兼顾肿瘤学的获益。因此临床医生需要全面评估患者的病情,依托有经验的MDT团队,依据每一位患者的具体情况随时制定有效的治疗方案,最终以患者受益最大化为治疗目标。Colorectal cancer with obstruction represents a prevalent acute abdominal condition frequently encountered in clinical practice.The patient population is primarily elderly,often presenting with comorbidities and advanced disease stages.This demographic profile correlates with a heightened incidence of perioperative complications and mortality,complicating management strategies significantly.Current therapeutic interventions encompass stoma creation,one-stage tumor resection accompanied by anastomosis,placement of stents or intestinal obstruction catheters,endoscopic procedures,as well as the classic Hartmann’s procedure or three-stage operations.Each treatment modality carries distinct advantages and disadvantages;therefore,it is essential to integrate oncological considerations into the decision-making process.Consequently,clinicians are required to perform a thorough evaluation of the patient’s overall health status and disease stage while collaborating closely with experienced multidisciplinary teams(MDT)to formulate individualized treatment plans for each case.The primary objective remains focused on optimizing patient outcomes.

关 键 词：结肠肿瘤 肠梗阻 急诊手术 

分 类 号：R73[医药卫生—肿瘤]