Cáncer de colon obstructivo

IF 0.2 Q4 MEDICINE, GENERAL & INTERNAL

Revista Medica Clinica Las Condes Pub Date : 2026-05-01 Epub Date: 2026-06-27 DOI:10.1016/j.rmclc.2026.05.004

Mario Abedrapo MD, Víctor Cortés MD

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Abstract

Colorectal cancer is the third most frequent worldwide. In Chile during 2020, 5 914 new cases were diagnosed. Its obstructive presentation is life-threatening due to the physiological disorder, in addition to its presentation in the elderly patients. Right colectomy with or without anastomosis is the recommended approach, while an ileostomy as a bridge to a right colectomy may be an alternative in patients with right-sided colon cancer. On the left, a colostomy allows for a posterior colectomy. The Hartmann procedure is valuable in perforated tumors, while subtotal or total colectomy is indicated in ischemia. In patients with colonic ischaemia or proximal perforation, one approach could be to perform an ileostomy, temporarily leaving the tumour in the patient, which may represent an alternative to colectomy. The placement of colonic stents can be considered an alternative to colostomy in experienced centers. In order to poor prognosis of metastatic carcinoma and the high morbidity of surgery, new strategies are warranted. This manuscript aims to demonstrate the different ways of managing the obstructive presentation of colorectal cancer.

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阻塞性结肠癌

结直肠癌是世界上第三常见的癌症。智利在2020年期间确诊了5 914例新病例。它的梗阻性表现是危及生命的，由于生理障碍，除了它的表现在老年患者。右结肠切除术合并或不合并吻合是推荐的方法，而回肠造口作为右结肠切除术的桥梁可能是右侧结肠癌患者的另一种选择。左图，结肠造口术允许后结肠切除术。Hartmann手术在穿孔肿瘤中是有价值的，而局部或全结肠切除术适用于局部缺血。对于结肠缺血或近端穿孔的患者，一种方法是进行回肠造口术，暂时将肿瘤留在患者体内，这可能是结肠切除术的另一种选择。在经验丰富的中心，结肠支架的放置可以被认为是结肠造口术的替代方案。由于转移性肿瘤预后差，手术发病率高，需要新的治疗策略。这份手稿的目的是展示不同的方法来管理梗阻性结直肠癌的表现。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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