外科理论与实践 ›› 2025, Vol. 30 ›› Issue (01): 79-83.doi: 10.16139/j.1007-9610.2025.01.15
孙强 综述, 张鑫, 姚骏, 王伟军 审校
收稿日期:
2023-11-10
出版日期:
2025-01-25
发布日期:
2025-04-25
基金资助:
SUN Qiang, ZHANG Xin, YAO Jun, WANG Weijun
Received:
2023-11-10
Online:
2025-01-25
Published:
2025-04-25
摘要:
癌症目前仍是全球人群死亡的主要原因,随着癌症早期筛查的推广和诊疗技术的发展,5年生存率逐渐升高,对癌症病人的全程管理也日益关注。但肿瘤相关急症的发生率仍较高,包括肿瘤初始表现、手术并发症、已知疾病的进展、既往癌症的复发和治疗的不良反应等引起的广泛急症,部分情况危及生命。本文综述了胃肠道肿瘤相关急症的现状和处置经验。
中图分类号:
孙强, 张鑫, 姚骏, 王伟军. 胃肠道肿瘤相关急症的现状与处置[J]. 外科理论与实践, 2025, 30(01): 79-83.
SUN Qiang, ZHANG Xin, YAO Jun, WANG Weijun. Current situation and management of gastrointestinal tumor-related emergencies[J]. Journal of Surgery Concepts & Practice, 2025, 30(01): 79-83.
[1] | BRAY F, FERLAY J, SOERJOMATARAM I, et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries[J]. CA Cancer J Clin, 2018, 68(6):394-424. |
[2] |
NARAYANSWAMI J, SMITH D A, ENZERRA M, et al. "-Omas" presenting as "-itis": acute inflammatory presentations of common gastrointestinal neoplasms[J]. Emerg Radiol, 2019, 26(4):433-448.
doi: 10.1007/s10140-019-01678-z pmid: 30719599 |
[3] | 龙平. 综合医院肿瘤急症的特点与救治[J]. 中华肿瘤防治杂志, 2020, 27(S01):181,183. |
LONG P. Characteristics and treatment of tumor emergency in general hospital[J]. Chin J Cancer Control, 2020, 27(S01):181,183. | |
[4] |
ZHOU Y, ABEL G A, HAMILTON W, et al. Diagnosis of cancer as an emergency: a critical review of current evidence[J]. Nat Rev Clin Oncol, 2017, 14(1):45-56.
doi: 10.1038/nrclinonc.2016.155 pmid: 27725680 |
[5] | ROSNER M H, DALKIN A C. Electrolyte disorders associated with cancer[J]. Adv Chronic Kidney Dis, 2014, 21(1):7-17. |
[6] | HWANG K, JEON D H, JANG H N, et al. Inappropriate antidiuretic hormone syndrome presenting as ectopic antidiuretic hormone-secreting gastric adenocarcinoma: a case report[J]. J Med Case Rep, 2014,8:185. |
[7] | GOULD ROTHBERG B E, QUEST T E, YEUNG S J, et al. A comprehensive review[J]. CA Cancer J Clin, 2022, 72(6):570-593. |
[8] |
LEGRAND S B. Modern management of malignant hypercalcemia[J]. Am J Hosp Palliat Care, 2011, 28(7):515-517.
doi: 10.1177/1049909111414164 pmid: 21724679 |
[9] | KHAN A A, GURNANI P K, PEKSA G D, et al. Bisphosphonate versus bisphosphonate and calcitonin for the treatment of moderate to severe hypercalcemia of malignancy[J]. Ann Pharmacother, 2021, 55(3):277-285. |
[10] | NAGY-MIGNOTTE H, SHESTAEVA O, VIGNOUD L, et al. Prognostic impact of paraneoplastic Cushing's syndrome in small-cell lung cancer[J]. J Thorac Oncol, 2014, 9(4):497-505. |
[11] |
ORONSKY B, MA P C, MORGENSZTERN D, et al. Nothing but NET: a review of neuroendocrine tumors and carcinomas[J]. Neoplasia, 2017, 19(12):991-1002.
doi: S1476-5586(17)30347-0 pmid: 29091800 |
[12] | COHEN A T, KATHOLING A, RIETBROCK S, et al. Epidemiology of first and recurrent venous thromboembolism in patients with active cancer. A population-based cohort study[J]. Thromb Haemost, 2017, 117(1):57-65. |
[13] | OBITSU T, TANAKA N, OYAMA A, et al. Efficacy and safety of low-molecular-weight heparin on prevention of venous thromboembolism after laparoscopic operation for gastrointestinal malignancy in Japanese patients: a multicenter, open-label, prospective, randomized controlled trial[J]. J Am Coll Surg, 2020, 231(5):501-509. |
[14] | STEVENS S M, WOLLER S C, BAUMANN KREUZIGER L, et al. Executive summary: antithrombotic therapy for VTE disease: second update of the CHEST guideline and expert panel report[J]. Chest, 2021, 160(6):2247-2259. |
[15] | HERMIE L, DHONDT E, VANLANGENHOVE P, et al. Empiric cone-beam CT-guided embolization in acute lower gastrointestinal bleeding[J]. Eur Radiol, 2021, 31(4):2161-2172. |
[16] | TRONCONE E, FUGAZZA A, CAPPELLO A, et al. Malignant gastric outlet obstruction: which is the best therapeutic option?[J]. World J Gastroenterol, 2020, 26(16):1847-1860. |
[17] | CHEN X J, CHEN G M, WEI Y C, et al. Palliative gastrectomy versus gastrojejunostomy for advanced gastric cancer with outlet obstruction: a propensity score matching analysis[J]. BMC Cancer, 2021, 21(1):188. |
[18] |
KAVANAGH D O, NOLAN B, JUDGE C, et al. A comparative study of short- and medium-term outcomes comparing emergent surgery and stenting as a bridge to surgery in patients with acute malignant colonic obstruction[J]. Dis Colon Rectum, 2013, 56(4):433-440.
doi: 10.1097/DCR.0b013e3182760506 pmid: 23478610 |
[19] |
NAMBA Y, HIRATA Y, MUKAI S, et al. Clinical indicators for the incidence of postoperative ileus after elective surgery for colorectal cancer[J]. BMC Surg, 2021, 21(1):80.
doi: 10.1186/s12893-021-01093-7 pmid: 33573636 |
[20] | 孙家琛, 陈俊榕, 刘亚男, 等. 肠梗阻导管联合生长抑素治疗老年胃肠道肿瘤术后早期炎性肠梗阻的临床疗效[J]. 中山大学学报:医学科学版, 2020, 41(5):741-746. |
SUN J C, CHEN J R, LIU Y N, et al. Effects of transnasal ileus tube combined with somatostatin on early postoperative inflammatory small bowel obstruction in elderly patients with gastrointestinal tumor[J]. J SUN YAT-SEN Univ(Med Sci), 2020, 41(5):741-746. | |
[21] | TAN K K, HONG C C, ZHANG J R, et al. Predictors of outcome following surgery in colonic perforation: an institution's experience over 6 years[J]. J Gastrointest Surg, 2011, 15(2):277-284. |
[22] |
DI CARLO S, FRANCESCHILLI M, ROSSI P, et al. Perforated gastric cancer: a critical appraisal[J]. Discov Oncol, 2021, 12(1):15.
doi: 10.1007/s12672-021-00410-z pmid: 35201463 |
[23] |
ISHIYAMA Y, MANABU AMIKI M O, ITO S. Anastomotic leakage following colorectal cancer surgery: comparison between conservative and surgical treatment[J]. Asian J Surg, 2021, 44(2):485-487.
doi: 10.1016/j.asjsur.2020.11.006 pmid: 33229124 |
[24] |
BIONDO S, GÁLVEZ A, RAMÍREZ E, et al. Emergency surgery for obstructing and perforated colon cancer: patterns of recurrence and prognostic factors[J]. Tech Coloproctol, 2019, 23(12):1141-1161.
doi: 10.1007/s10151-019-02110-x pmid: 31728784 |
[25] | LINGAMANENI P, DESAI P, VENNIKANDAM M M, et al. Tumor lysis syndrome in a patient with gastric adenocarcinoma[J]. J Investig Med High Impact Case Rep, 2020,8:2324709620933427. |
[26] | KOIZUMI W, NAKAYAMA N, TANABE S, et al. A multicenter phase Ⅱ study of combined chemotherapy with docetaxel, cisplatin, and S-1 in patients with unresectable or recurrent gastric cancer (KDOG 0601)[J]. Cancer Chemother Pharmacol, 2012, 69(2):407-413. |
[27] | ECKSTROM J, BARTELS T, ABRAHAM I, et al. A single-arm, retrospective analysis of the incidence of febrile neutropenia using same-day versus next-day pegfilgrastim in patients with gastrointestinal cancers treated with FOLFOX or FOLFIRI[J]. Support Care Cancer, 2019, 27(3):873-878. |
[28] | MILLER K D, NOGUEIRA L, MARIOTTO A B, et al. Cancer treatment and survivorship statistics,2019[J]. CA Cancer J Clin, 2019, 69(5):363-385. |
[29] | WANG H, WANG L, JIANG Y L, et al. Long-term outcomes and prognostic analysis of computed tomography-guided radioactive 125I seed implantation for locally recurrent rectal cancer after external beam radiotherapy or surgery[J]. Front Oncol, 2021,10:540096. |
[30] |
ANDREYEV H J, DAVIDSON S E, GILLESPIE C, et al. Practice guidance on the management of acute and chronic gastrointestinal problems arising as a result of treatment for cancer[J]. Gut, 2012, 61(2):179-192.
doi: 10.1136/gutjnl-2011-300563 pmid: 22057051 |
[31] | 刘越, 盛晶, 赵得堡, 等. 5-氟尿嘧啶/亚叶酸钙+奥沙利铂+伊立替康方案在老年晚期胃癌姑息治疗中的临床疗效[J]. 癌症进展, 2020, 18(24):2551-2554. |
LIU Y, SHENG J, ZHAO D B, et al. Clinical efficacy of 5-fluorouracil/calcium folin + oxaliplatin + irinotecan in palliative treatment of advanced gastric cancer in elderly patients[J]. Cancer Adv, 2020, 18(24):2551-2554. | |
[32] | ZHONG L, LI Y S, XIONG L, et al. Small molecules in targeted cancer therapy: advances,challenges,and future perspectives[J]. Signal Transduct Target Ther, 2021, 6(1):201. |
[33] | ZHANG J, LUO D, LI F, et al. Ginsenoside Rg3 alle-viates antithyroid cancer drug vandetanib-induced QT interval prolongation[J]. Oxid Med Cell Longev, 2021,2021:3520034. |
[34] | NIE C, LV H, CHEN B, et al. High DCR and better survival in patients with advanced or metastatic gastric cancer receiving anti-angiogenic TKI plus chemotherapy: a real-world study[J]. Technol Cancer Res Treat, 2023,22:15330338221150561. |
[35] |
AGIRGOL S, ÇAYTEMEL C, PILANCI K N. Dermatological side effects of targeted antineoplastic therapies: a prospective study[J]. Cutan Ocul Toxicol, 2020, 39(4):380-384.
doi: 10.1080/15569527.2020.1833028 pmid: 33028137 |
[36] | JIANG L Y, PING L, YAN H, et al. Cardiovascular toxi-city induced by anti-VEGF/VEGFR agents: a special focus on definitions,diagnoses,mechanisms and management[J]. Expert Opin Drug Metab Toxicol, 2020, 16(9):823-835. |
[37] |
DING F, LIU B, WANG Y. Risk of hand-foot skin reaction associated with vascular endothelial growth factor-tyrosine kinase inhibitors: a meta-analysis of 57 randomized controlled trials involving 24,956 patients[J]. J Am Acad Dermatol, 2020, 83(3):788-796.
doi: S0190-9622(19)30607-3 pmid: 30991119 |
[38] | HAANEN J B A G, CARBONNEL F, ROBERT C, et al. Management of toxicities from immunotherapy: ESMO clinical practice guidelines for diagnosis, treatment and follow-up[J]. Ann Oncol, 2017, 28(suppl 4):iv119-iv142. |
[39] |
MOSLEHI J J, SALEM J E, SOSMAN J A, et al. Increased reporting of fatal immune checkpoint inhibitor-associated myocarditis[J]. Lancet, 2018, 391(10124):933.
doi: S0140-6736(18)30533-6 pmid: 29536852 |
[40] | KOOSHKAKI O, DERAKHSHANI A, HOSSEINKHANI N, et al. Combination of ipilimumab and nivolumab in cancers: from clinical practice to ongoing clinical trials[J]. Int J Mol Sci, 2020, 21(12):4427. |
[41] | HIGASHI T, MIYAMOTO H, YOSHIDA R, et al. Sjögren's syndrome as an immune-related adverse event of nivolumab treatment for gastric cancer[J]. Intern Med, 2020, 59(20):2499-2504. |
[1] | 王玉蓉, 汪元元, 翁海燕. 胃肠道平滑肌肉瘤临床病理分析3例报告[J]. 诊断学理论与实践, 2024, 23(05): 537-541. |
[2] | 陈海燕, 杨小宝, 许大康. 新生物标志物在胃肠道肿瘤中疗效预测和预后价值的研究进展[J]. 诊断学理论与实践, 2019, 18(06): 704-710. |
[3] | 郑民华, 臧潞, 马君俊,. 重视腹腔镜胃肠道肿瘤手术的消化道重建[J]. 外科理论与实践, 2014, 19(02): 93-96. |
[4] | 叶静,. 急诊学科发展与基础科学研究[J]. 内科理论与实践, 2012, 7(01): 23-24. |
[5] | 陆一鸣, 叶静,. 如何推动我国急诊医学事业的发展[J]. 内科理论与实践, 2012, 7(01): 1-5. |
[6] | 潘曙明, 刘佳福,. 急性缺血性脑卒中的溶栓治疗:急诊医学的新机遇[J]. 内科理论与实践, 2012, 7(01): 20-22. |
[7] | . 第三届首都急诊医学高峰论坛[J]. 内科理论与实践, 2010, 5(04): 285-. |
[8] | 徐庆,. 胃肠道肿瘤病人伴有肝硬化门静脉高压症的处理原则是什么?[J]. 外科理论与实践, 2009, 14(01): 88-. |
[9] | 杨秀疆,. 内镜超声检查在食管及胃肠肿瘤术前分期评估中的价值[J]. 诊断学理论与实践, 2008, 7(06): 602-604. |
[10] | 蔡蕾, 焦海宁, 喇端端,. 卵巢Krukenberg瘤的临床诊治(附20例分析)[J]. 诊断学理论与实践, 2008, 7(02): 176-180. |
[11] | 张华,吴达明,陈克敏. 介入放射学在急诊医学中的应用(1)[J]. 诊断学理论与实践, 2004, 3(02): 86-87. |
[12] | 谢爽,王鸿利. 实验诊断在急诊医学中的地位[J]. 诊断学理论与实践, 2004, 3(02): 82-85. |
[13] | 杜卫东,袁祖荣,唐健雄,沈达明,程爱群,于晓峰,钱敏,竺越. 进展期胃肠道肿瘤术后联合化疗的临床疗效观察[J]. 外科理论与实践, 2003, 8(05): 383-386. |
[14] | 杜卫东,唐健雄,袁祖荣,程爱群,杨俭英,竺越. 胃肠道肿瘤术后经埋入式化疗泵腹腔化疗的并发症及其防治[J]. 外科理论与实践, 2003, 8(03): 252-253. |
[15] | 王斌,花天放,李继坤,曹俊,张伟萍. 营养支持对消化道肿瘤病人术后营养状况和免疫功能的影响[J]. 外科理论与实践, 2002, 7(01): 23-26. |
阅读次数 | ||||||
全文 |
|
|||||
摘要 |
|
|||||