Breaking the "intestinal" rule! Changsha Fourth Hospital's precise surgery helps a 94-year-old intestinal cancer patient regain his life

For a long time, advanced age has been regarded as one of the major challenges of surgical treatment, because patients often have multiple underlying diseases, organ dysfunction and other complex conditions, and the risk of surgery is extremely high.

Recently, the Gastrointestinal Bariatric Surgery and Anesthesia Surgery Department of Changsha Fourth Hospital, unafraid of the challenge of advanced age, rose to the challenge and successfully performed a radical resection of rectal cancer on a 94-year-old patient with rectal cancer and nearly 20 underlying diseases. The patient recovered well after the operation and has been discharged smoothly.

Grandma Cai is 94 years old this year. In the past month, she has repeatedly had blood in her stool, abdominal pain, and occasional general fatigue. After receiving the patient, the gastrointestinal bariatric surgery department initially determined that the abdominal pain was caused by a tumor blocking the intestine. After a colonoscopy, it was confirmed that the patient had a tumor at the rectal-sigmoid junction, and that the tumor had blocked the intestinal cavity. The bleeding from the tumor also caused the patient to be anemic.

The repeated abdominal pain has brought great pain to Grandma Cai, and she has been unable to eat due to intestinal obstruction. If the tumor progresses, her life will be threatened. Only radical surgery for rectal cancer can help relieve the pain, improve her quality of life, and prolong her life.

However, operating on a cancer patient in his 90s is extremely risky. Especially since the old man has a history of coronary heart disease for more than 20 years, and has 19 complications including lower gastrointestinal bleeding, melanosis coli, multiple rectal polyps, grade 3 hypertension (high risk), coronary heart disease, heart failure, lung infection, severe anemia, etc. The complexity, difficulty and risk of the operation can be imagined. This is a major test for both the surgeon and the anesthesiologist.

Faced with numerous difficulties, the gastrointestinal bariatric surgery team did not compromise and invited multidisciplinary experts from the Department of Hematology and Oncology, Department of Respiratory and Critical Care Medicine, Department of Gastroenterology, Department of Anesthesia and Surgery, Department of Medical Imaging, and Department of Pathology to conduct MDT discussions and fully assess the risks of surgery. After repeated and careful research and discussion, a thorough treatment plan and contingency plan were finally formulated.

After completing the preoperative preparations, Liu Jiefeng, director of the gastrointestinal bariatric surgery department and chief physician, led the team to work closely with the anesthesia and surgery department to successfully perform laparoscopic radical resection of rectal cancer for the elderly man.

Under the careful treatment of the gastrointestinal bariatric surgery medical team, the old man recovered very smoothly and safely passed through "barriers" such as intestinal bleeding, intestinal fistula, wound infection, and anastomotic stenosis, without any postoperative complications.

One week after the operation, Grandma Cai gradually resumed her normal diet and was discharged from the hospital. Grandma Cai's family sincerely praised the high level of medical technology of the gastrointestinal bariatric surgery team and sent a banner to express their gratitude.

Dispelling Myths

Advanced age is not a "forbidden zone" for surgery

Liu Jiefeng said that during diagnosis and treatment, many elderly cancer patients were tortured by the pain of the disease, but when they heard that they had to undergo surgery, they immediately refused: "At such an old age, why should I endure this hardship?"

But in fact, with the advancement of medical equipment, surgical techniques, anesthesia management, postoperative care and other aspects, age is no longer a factor in determining whether to undergo surgery. Compared with age, overall physical condition is a more important influencing factor.

Elderly patients have decreased organ function, decreased tolerance, and multiple cardiovascular and cerebrovascular complications. The risk of surgery is indeed much higher than that of ordinary people. A detailed examination is required before surgery, and a comprehensive assessment is required before deciding whether surgery is appropriate.

If the systemic condition is serious, surgery needs to be postponed and supportive treatment should be carried out first to create the conditions for surgery. For those who are in a physical condition that can tolerate surgery, such as Grandma Cai, surgery can be used to resume normal life.

Of course, from a medical point of view, any surgery has certain risks, but laparoscopic radical resection of rectal cancer is already very mature, with a surgical incision of only 3-4CM, or even no incision, and less bleeding during the operation. Patients feel less pain after surgery, can get out of bed and move around early, and recover faster.

Therefore, if a disease is discovered at an advanced age, medical treatment should be sought promptly so that “early diagnosis and early treatment” of the disease can be achieved as much as possible in order to obtain better treatment results.

Liu Jiefeng said that in the Gastrointestinal Bariatric Surgery Department of Changsha Fourth Hospital, "super-elderly" colorectal cancer surgery patients like Grandma Cai are no longer isolated cases. The department has rich experience and can provide escort for elderly surgical patients.

Hunan Medical Chat Special Author: Yang Suo and Chen You from Changsha Fourth Hospital

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(Edited by YT)