Department of Surgical Oncology, University of Groningen, University Medical Center Groningen, HPC BA31, P.O. Box 30.001, 9700 RB Groningen, The Netherlands.
Cancer Treat Rev. 2014 Sep;40(8):1028-36. doi: 10.1016/j.ctrv.2014.05.005. Epub 2014 May 22.
An oncologic emergency is defined as an acute, potentially life threatening condition in a cancer patient that has developed as a result of the malignant disease or its treatment. Many oncologic emergencies are signs of advanced, end-stage malignant disease. Oncologic emergencies can be divided into medical or surgical. The literature was reviewed to construct a summary of potential surgical emergencies in oncology that any surgeon can be confronted with in daily practice, and to offer insight into the current approach for these wide ranged emergencies. Cancer patients can experience symptoms of obstruction of different structures and various causes. Obstruction of the gastrointestinal tract is the most frequent condition seen in surgical practice. Further surgical emergencies include infections due to immune deficiency, perforation of the gastrointestinal tract, bleeding events, and pathological fractures. For the institution of the appropriate treatment for any emergency, it is important to determine the underlying cause, since emergencies can be either benign or malignant of origin. Some emergencies are well managed with conservative or non-invasive treatment, whereas others require emergency surgery. The patient's performance status, cancer stage and prognosis, type and severity of the emergency, and the patient's wishes regarding invasiveness of treatment are essential during the decision making process for optimal management.
肿瘤急症是指癌症患者由于恶性肿瘤或其治疗而导致的急性、潜在危及生命的状况。许多肿瘤急症是晚期恶性肿瘤的表现。肿瘤急症可分为内科急症和外科急症。本文复习了相关文献，总结了任何外科医生在日常实践中都可能遇到的潜在肿瘤外科急症，并对这些广泛急症的当前处理方法进行了探讨。癌症患者可能会出现不同结构和不同原因引起的梗阻症状。胃肠道梗阻是外科实践中最常见的情况。进一步的外科急症包括免疫缺陷引起的感染、胃肠道穿孔、出血事件和病理性骨折。为了对任何急症进行适当的治疗，确定潜在病因很重要，因为急症可能是良性或恶性的。一些急症可以通过保守或非侵入性治疗得到很好的控制，而另一些则需要紧急手术。在制定最佳治疗决策时，患者的一般状况、癌症分期和预后、急症的类型和严重程度以及患者对治疗侵袭性的意愿都是至关重要的。
