ObjectiveTo investigate the diagnosis, treatment, and prognosis of the postoperative intestinal obstruction of gastrointestinal cancer. MethodThe clinical data of 58 patients with postoperative intestinal obstruction of gastrointestinal cancer from January 2011 to January 2013 were analyzed retrospectively. ResultsIn 58 patients with postoperative intestinal obstruction, there were 46 cases of incomplete intestinal obstruction, 12 cases of complete obstruction. Seventeen cases were treated conservatively and 41 cases were accepted laparotomy. The surgical exploration found that there were 4 cases of strangulated abdominal internal hernia, 4 cases of volvulus, 1 case of stercoral obstruction, 2 cases of intussusception, 9 cases of adhesive intestinal obstruction, and 21 cases of tumor recurrence. There were 32 patients with high tumor markers before laparotomy, including 19 cases of tumor recurrence. Fourteen cases had no obvious tumor lesions detected by PET-CT, but recurrence and metastasis were found by surgical exploration. ConclusionsThe recurrent postoperative intestinal obstruction of gastrointestinal cancer mostly means recurrence and metastasis, with poor prognosis. Early laparotomy may improve the prognosis and the quality of life, elevated tumor markers have some links with tumor recurrence and PET-CT is not sensitive for multiple nodular metastases.
目的探討低位局部進展期直腸癌新輔助放化療后完全緩解病例的進一步治療方案及效果。 方法回顧性分析江蘇省中醫院腫瘤外科2008年1月至2010年5月期間行新輔助放化療后初步判斷達到病理完全緩解（pCR）的14例低位局部進展期直腸癌患者的臨床資料。 結果14例患者中接受手術者10例，術后真正達到pCR者5例；術后2例復發或轉移，其中死亡1例，1例帶瘤生存，余8例患者均無瘤生存。未行手術的4例患者中，有3例復發或轉移，其中2例死亡，1例帶瘤生存；余1例無瘤生存。4例未行手術病例中CEA水平正常者（<5 μg/L）2例（1例復發或轉移），CEA升高的2例均發生轉移；10例手術病例中CEA水平正常者6例（均無瘤生存，4例真正達到pCR），升高者4例（1例真正達到pCR，2例復發或轉移）。 結論接受新輔助放化療后初步判斷達到pCR的病例，尤其是CEA值高于正常者，應接受規范的全直腸系膜切除（TME）手術以達到根治的目的。