南非中央医院对恶性结直肠阻塞的经验
概括
结肠直肠癌 (CRC) 阻塞在LMIC中很常见,影响年轻患者. 切除是常见的,但口腔管比支架更常用,与高收入国家不同.
科学领域:
- 在瘤学瘤学.
- 胃肠病学 胃肠病学
- 公共卫生 公共卫生
背景情况:
- 结肠直肠癌 (CRC) 阻塞在低至中等收入国家 (LMICs) 没有得到充分研究.
- 了解LMICs中的阻塞模式对于制定卫生政策至关重要.
研究的目的:
- 在LMIC环境中调查结直肠癌 (CRC) 呈现阻塞的频谱和结果.
- 提供关于阻碍性CRC管理的数据和健康政策见解的结果.
主要方法:
- 从CRC (2000-2019) 获得大肠阻塞的510名患者的回顾性分析.
- 数据包括瘤特征,管理策略 (切除,结肠直肠,支架),切除边缘和瘤结果.
- 患者的随访包括复发和无病间隔.
主要成果:
- 20%的CRC患者出现了阻塞,平均年龄为57岁.
- 第三阶段 (34.5%) 和第四阶段 (26.5%) 的疾病是常见的;中度差异化癌症是普遍的 (65.6%).
- 在72.5%的病例中进行了切除,在24.1%的病例中进行了转向大肠切除,在10.8%的病例中进行了支架. 在所有患者中,复发发生在6.7%的患者中.
结论:
- 五分之一的结直肠癌 (CRC) 病例呈现出阻塞,患者年龄小于高收入国家 (HIC) 系列.
- 超过70%的阻塞性CRC病例进行了切除.
- 胃口被使用的频率是支架的两倍,这是HIC实践的逆转.
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