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Occlusion colique: traitement chirurgical et/ou prothèse?

Colonic occlusion: surgical treatment and/or stent?

  • Mise Au Point
  • Published:
Acta Endoscopica

Résumé

Soixante-dix pour cent des occlusions coliques sont d’origine tumorale. En France, le cancer colorectal est, tous sexes confondus, le premier cancer en terme d’incidence annuelle. Dans 7 à 29% des cas, ce cancer se révèle par un syndrome occlusif aigu, total ou subtotal, la majorité de ces occlusions tumorales se situant au niveau du côlon gauche. En terme de pronostic, l’occlusion est une variable pronostique péjorative indépendante, car elle est le plus souvent le témoin d’un cancer évolué et impose un geste de décompression d’urgence chez une personne le plus souvent âgée, en mauvais état général. Traditionnellement, elle relève d’un traitement chirurgical mais le développement des techniques de désobstruction endoscopique par prothèse métallique, ne nécessitant pas obligatoirement d’anesthésie générale, amène à discuter le rôle respectif de la chirurgie et de l’endoscopie dans le traitement des occlusions coliques tumorales.

Abstract

Seventy percent of colonic occlusions have a tumour origin. In France, colorectal cancer is, for both sexes combined, the first cancer in terms of annual incidence. In 7 to 29% of cases, this cancer is revealed by a total or subtotal acute occlusive syndrome, with the majority of tumoral occlusions situated in the left colon. In terms of prognosis, occlusion is an independent pejorative prognosis, because it is most often the sign of advanced cancer and requires that actions be taken for emergency decompression, often in an elderly patient in poor overall health. Traditionally, this has involved surgery however the development of endoscopic desobstruction using metallic stents, which does not necessarily require general anaesthesia, has raised the question of the respective role of surgery and end oscopy in the treatment of tumoral colonic occlusions.

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  1. Clinique Beau Soleil, 119, avenue de Lodève, F-34070, Montpeller, France

    P. Bauret

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  1. P. Bauret
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Bauret, P. Occlusion colique: traitement chirurgical et/ou prothèse?. Acta Endosc 38, 348–358 (2008). https://doi.org/10.1007/s101900800017

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  • DOI: https://doi.org/10.1007/s101900800017

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