Callaghan J
Department of Surgery, Winneshiek County Memorial Hospital, Decorah, Iowa.
Am J Surg. 1990 Mar;159(3):277-80; discussion 281. doi: 10.1016/s0002-9610(05)81216-4.
Over a 20-year period, 168 cases of colorectal cancer were treated in a 50-bed rural hospital by 1 surgeon. The majority of the patients were older than 70 years of age. The stage of disease was comparatively advanced, with 71% of the patients having nodal or distant metastases, 19% with bowel obstruction, and 8% with perforation. The operability and resectability rates were 100% and 96%, respectively. The crude 5-year survival was 50% for the entire series. The 5-year survival after curative operations in which there was no gross residual tumor at the end of the operation was 63%, and the 5-year survival for resection of localized node-negative disease was 81%. The wound infection rate was 2%, and the operative mortality rate was 1% for combined elective and emergency operations. The results of treatment of colorectal cancer in small rural hospitals are infrequently reported, and this series may be compared with the published results from large teaching institutions.
在20年的时间里，一名外科医生在一家拥有50张床位的乡村医院治疗了168例结直肠癌患者。大多数患者年龄超过70岁。疾病分期相对较晚，71%的患者有淋巴结转移或远处转移，19%的患者有肠梗阻，8%的患者有穿孔。可手术率和可切除率分别为100%和96%。整个系列的5年粗生存率为50%。手术结束时无肉眼残留肿瘤的根治性手术后的5年生存率为63%，局限性淋巴结阴性疾病切除后的5年生存率为81%。伤口感染率为2%，择期和急诊联合手术的手术死亡率为1%。乡村小医院结直肠癌的治疗结果鲜有报道，本系列可与大型教学机构公布的结果进行比较。
