Baer Canaan, Menon Raman, Bastawrous Sarah, Bastawrous Amir
Colon and Rectal Clinic, Swedish Medical Center, 1101 Madison, Suite 500, Seattle, WA 98104, USA.
Colon and Rectal Clinic, Swedish Medical Center, 1101 Madison, Suite 500, Seattle, WA 98104, USA.
Surg Clin North Am. 2017 Jun;97(3):529-545. doi: 10.1016/j.suc.2017.01.004.
Many colorectal carcinomas will present emergently with issues such as obstruction, perforation, and bleeding. Emergency surgery is associated with poor short- and long-term outcomes. For abnormality localizing to the colon proximal to the splenic flexure, surgical management with hemicolectomy is often a safe and appropriate approach. Obstructions are more common in the distal colon, however, where there is an evolving spectrum of surgical and nonsurgical options, most notably by the development of endoluminal stents. Perforation and bleeding are managed similarly to benign causes, as malignancy may be only part of a differential diagnosis at the time of an operation.
许多结直肠癌会因肠梗阻、穿孔和出血等问题而紧急就诊。急诊手术的短期和长期预后都较差。对于脾曲近端结肠的病变，行半结肠切除术的手术治疗通常是一种安全且合适的方法。然而，梗阻在远端结肠更为常见，在远端结肠有一系列不断发展的手术和非手术选择，最显著的是腔内支架的应用。穿孔和出血的处理与良性病因相似，因为在手术时恶性肿瘤可能只是鉴别诊断中的一部分。
