Lorusso Curzio, Palazzo Paola, Merlicco Domenico
Unità Operativa di Chirurgia Generale "A. De Blasi" D.A.C.T.I., Sezione di Chirurgia Generale e Toracica, Università degli Studi di Bari.
Ann Ital Chir. 2005 Jul-Aug;76(4):353-5.
To analyse the risk factors in the treatment of intestinal obstruction due to colorectal carcinoma. The treatment of neoplastic obstruction of the right colon until the splenic flexure is well defined: right hemicolectomy, enlarged right hemicolectomy. Otherwise the treatment of the obstruction due to left colon carcinoma beyond left flexure is not standardized.
The Authors report on a consecutive series of 15 patients, classified according to Colorectal Tumours Emergencies Score (CTES), based on the analysis of 4 risks factors: colic, perforation, serum albumin, concurrent cardiovascular disease, chronic renal insufficiency. Each patient has been ranked in three classes of risk: low (CTES < 4), moderate (CTES 4-12), and high (CTES > 12).
Referring to this classification the Authors consider the choice of surgical treatment. When general conditions of the patient permit, it seems preferable to perform primary anastomosis.
分析结直肠癌所致肠梗阻治疗中的危险因素。右半结肠癌至脾曲的肿瘤性梗阻的治疗已明确:右半结肠切除术、扩大右半结肠切除术。否则,左半结肠癌超过左曲所致梗阻的治疗尚无标准化方案。
作者报告了连续的15例患者,根据结直肠肿瘤急症评分(CTES)进行分类,该评分基于对4个危险因素的分析:绞痛、穿孔、血清白蛋白、并发心血管疾病、慢性肾功能不全。每位患者被分为三个风险等级:低(CTES<4)、中(CTES 4 - 12)、高(CTES>12)。
参考此分类,作者考虑手术治疗的选择。当患者一般情况允许时,进行一期吻合似乎更可取。