台中一名蔡阿嬤被檢查出升結腸有一顆4-5公分大的惡性腫瘤，腫瘤堵住了正常腸道，造成阿嬤無法排便，引起嚴重的腹脹、嘔吐、食慾不佳，為了保命不得不進行腸造口手術，但卻併發皮膚炎，每次更換便袋就得忍受撕皮的痛楚。經光田大腸直腸外科團隊研究後，決定以腹腔鏡方式手術移除腫瘤，讓老婦不用再忍受腸造口的不便。
光田綜合醫院大腸直腸外科主任吳喬森指出，阿嬤的腸造口是因為她日前被檢查出升結腸有一顆4-5公分大的惡性腫瘤，腫瘤堵住了正常腸道，造成阿嬤無法排便，引起嚴重的腹脹、嘔吐、食慾不佳，若不緊急治療將可能有腸穿孔或缺血壞死的風險，甚至病況嚴重的話可能引發致命敗血症。
蔡阿嬤因為很能忍痛，當家人發現不對勁時，阿嬤已經嚴重腹水，腹部器官都泡在腹水中，且長時間沒食慾、吃不下東西的情況下嚴重營養不足。當時為了救命，外科醫師先緊急幫她開了腸造口，讓排泄正常，同時在家人細心照顧下，阿嬤精神逐漸恢復，沒想到腸造口併發皮膚糜爛成了阿嬤的夢魘。
蔡子形容，母親每更換一次便袋就得忍受撕皮痛楚，腸造口四周都破皮，「但媽媽從沒埋怨過，更不會靠脾氣，每次都自己忍耐，溫和的讓家人協助她換便袋」，但家人實在不忍心看她痛苦，到處詢問有沒有可以根除腸造口皮膚糜爛的方法。
吳喬森評估蔡阿嬤身體狀況，發現阿嬤除了腸造口問題外，心肺功能、體力狀態經過家人調養後都非常好，決定幫阿嬤施做微創腹腔鏡手術，在腹部開3個小傷口切除腫瘤，同時接通大、小腸、關閉腸造口，讓阿嬤重拾生活品質，目前只要口服化療藥物且定期追蹤即可。
吳喬森解釋，隨著年齡的增長，銀髮族身體機能逐漸退化，對藥物的承受能力較低，接受手術及麻醉風險也相對來的高，加上多常會伴隨著慢性疾病，以及心肺功能退化、器官老化等狀況，因此在選擇手術治療上的風險更難以掌握。
他說，台灣進入高齡社會，銀髮醫療越顯重要，另一方面高齡者常擔憂會連累家人而忍痛，通常就醫時可能都已經很嚴重，提醒照顧者要留意家中長輩有無異狀。
幸運的是現代醫療發展越來越成熟且多元，比起傳統剖腹手術，腹腔鏡手術的好處是手術過程只需要在患者腹部打幾個小洞，經過腹腔鏡的放大效果及超高解析影像，可以幫助外科醫師對病灶部位有更清楚的視野，再加上許多科技先進儀器的協助下，腹腔鏡手術對患者的創傷小，術後復原更快、效果更好，對高齡者來說更為安全。銀髮病患只要經專業醫師術前評估後以手術來切除病灶，有助於維持生活品質才是最重要的！
吳喬森醫師提醒，一般來說大腸癌的緣起都是由於正常的腸道細胞接受了來自於環境中的各種毒物之後，慢慢變成息肉，最後再突變成大腸癌，這個過程稱為腺瘤腺癌序列(adenoma-carcinoma sequence)。統計起來，這個過程所需要的時間約在10年左右，所以基本上，只要能每3～5年接受一次完整全大腸鏡的檢查，應可有效預防息肉癌變的可能。
建議飲食不規律，嗜吃燒烤、油炸或醃漬類食物的民眾，慢性大腸發炎性疾病的患者，有大腸直腸癌或是大腸息肉家族史的民眾，是大腸癌好發族群，最好的預防方式就是定期接受大腸鏡檢查。
A Tai Ai Chai Aunt was found to have a 4-5 cm large malignant tumor in the ascending colon. The tumor blocked the normal intestine, causing the aunt to lose bowel movements, causing severe abdominal distension, vomiting, and poor appetite. No enterostomy is performed, but dermatitis is complicated. Every time you change your pocket, you have to endure the pain of tearing. After research by the Guangtian Large Intestine Rectal Surgery team, it was decided to remove the tumor by laparoscopic surgery, so that the elderly woman no longer has to endure the inconvenience of the intestinal stoma.
Wu Qiaosen, director of the colorectal and rectal surgery at Guangtian General Hospital, pointed out that the aunt's intestines were caused by a 4-5 cm large malignant tumor that she had been examined for ascending colon, and the tumor blocked the normal intestine, causing the aunt to be unable to defecate. Causes severe abdominal distension, vomiting, and poor appetite. If it is not treated urgently, there may be a risk of intestinal perforation or ischemic necrosis. Even if the condition is serious, it may cause fatal sepsis.
Because Aunt Cai was very reluctant, when the family found that something was wrong, the aunt had severe ascites, the abdominal organs were soaked in the ascites, and there was a serious undernutrition in the absence of appetite or eating for a long time. At that time, in order to save lives, the surgeon first helped her to open the intestines for excretion, and at the same time, under the careful care of the family, the aunt's spirit gradually recovered. I didn't expect the intestinal ostomy and the skin to become a nightmare.
Cai Zi described that every time the mother changed her pocket, she had to endure the pain of tearing her skin. The mother's mouth was broken around her skin. "But my mother never complained, and she didn't rely on her temper. She endured herself every time and gently assisted her family. She changed bags, but the family couldn't bear to see her pain, and asked if there was any way to eradicate the skin erosion of the intestines.
Wu Qiaosen assessed the physical condition of Auntie Cai and found that in addition to the problem of intestinal stoma, the cardiopulmonary function and physical state were very good after the family was nursed back to health. He decided to help Auntie to perform minimally invasive laparoscopic surgery and open 3 small wounds in the abdomen. The tumor is removed, and the large and small intestines are closed at the same time, and the intestinal stoma is closed, so that the aunt can regain the quality of life. At present, oral chemotherapy drugs can be used and tracked regularly.
Wu Qiaosen explained that with the increase of age, the physical function of the silver-haired people is gradually degraded, the ability to withstand drugs is low, the risk of surgery and anesthesia is relatively high, and often accompanied by chronic diseases, as well as degeneration of heart and lung function, organs Conditions such as aging, so the risk of choosing surgical treatment is more difficult to grasp.
He said that when Taiwan enters a senior society, silver-haired medical care becomes more and more important. On the other hand, elderly people often worry that they will suffer from family problems. They may be very serious when they go to hospital, reminding caregivers to pay attention to whether there are any abnormalities in their elders.
Fortunately, modern medical development is more and more mature and diverse. Compared with traditional laparotomy, the advantage of laparoscopic surgery is that the surgery only needs to make a few holes in the patient's abdomen, after laparoscopic amplification and ultra-high resolution images. It can help surgeons have a clearer view of the lesions. With the help of many advanced scientific and technological instruments, laparoscopic surgery has less trauma to the patient, faster recovery and better effect, especially for the elderly. Safety. It is the most important thing for a silver-stricken patient to use a surgery to remove a lesion after surgery by a professional physician to help maintain the quality of life!
Dr. Wu Qiaosen reminded that in general, the origin of colorectal cancer is due to the fact that normal intestinal cells receive various poisons from the environment, then slowly become polyps, and finally mutate into colorectal cancer. This process is called adenoma. Sequence (adenoma-carcinoma sequence). Statistically, the time required for this process is about 10 years, so basically, as long as you can receive a complete gutoscopy every 3 to 5 years, it should be effective to prevent the possibility of polyp cancer.
It is recommended that people with irregular diet, people who eat barbecue, fried or pickled foods, patients with chronic large intestine inflammatory diseases, people with colorectal cancer or family history of colorectal polyps, are the most common cause of colorectal cancer, the best prevention The way is to receive colonoscopy regularly.
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