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梗阻性结肠癌急诊手术与择期手术的比较:一项回顾性研究。

Comparison of emergency surgeries for obstructed colonic cancer with elective surgeries: A retrospective study.

作者信息

Sucullu Ilker, Ozdemir Yavuz, Cuhadar Mehmet, Balta Ahmet Ziya, Yucel Ergun, Filiz Ali Ilker, Gulec Bulent

机构信息

Ilker Sucullu, Associate Professor, Department of General Surgery, GATA Haydarpasa Training Hospital, Istanbul, Turkey.

Yavuz Ozdemir, Assistant Professor, Department of General Surgery, GATA Haydarpasa Training Hospital, Istanbul, Turkey.

出版信息

Pak J Med Sci. 2015 Nov-Dec;31(6):1322-7. doi: 10.12669/pjms.316.8277.

Abstract

OBJECTIVE

Colon cancer patients presented with obstruction were known to have worse postoperative morbidity and mortality rates, but conflicting data has been reported in recent years. We aimed to investigate postoperative complication rates, and short and long-term oncological outcomes in patients with colon cancer treated with either emergency surgery due to obstruction or elective surgery.

METHODS

Two hundred fifty two patients were analyzed. Patients presented with obstruction and underwent an emergency surgery, and patients operated under elective circumstances were compared according to their demographic variables, tumor characteristics, and short and long term treatment outcomes.

RESULTS

Distribution of age, gender and comorbidities were similar between both the groups. Need for an end colostomy was significantly higher in obstructed patients (22.7% vs 1.6%, respectively). Obstructed patients were tending to be at an advanced stage. Postoperative morbidity and mortality, and prognosis of colon cancer patients presented with obstruction is worse than patients operated under elective circumstances.

CONCLUSIONS

Colon cancer patients presented with obstruction constitutes more than one quarter of all patients. These patients have significantly higher morbidity and mortality rates. Obstructed colon cancer usually appears at advanced stage. Primary resection and anastomosis is safe in most of the cases.

摘要

目的

已知结肠癌伴梗阻患者术后发病率和死亡率更高,但近年来报道的数据相互矛盾。我们旨在调查因梗阻接受急诊手术或择期手术的结肠癌患者的术后并发症发生率以及短期和长期肿瘤学结局。

方法

分析了252例患者。将因梗阻接受急诊手术的患者与择期手术患者根据其人口统计学变量、肿瘤特征以及短期和长期治疗结局进行比较。

结果

两组患者的年龄、性别和合并症分布相似。梗阻患者行末端结肠造口术的需求显著更高(分别为22.7%和1.6%)。梗阻患者往往处于晚期。结肠癌伴梗阻患者的术后发病率、死亡率及预后均比择期手术患者差。

结论

结肠癌伴梗阻患者占所有患者的四分之一以上。这些患者的发病率和死亡率显著更高。梗阻性结肠癌通常出现在晚期。大多数情况下,一期切除吻合术是安全的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/78fa/4744275/bfb022e9b3e2/PJMS-31-1322-g001.jpg

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