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结直肠癌确诊时约20%~25%的患者合并远处转移[1]。转移灶及原发灶的R0切除是Ⅳ期转移性结直肠癌(metastatic colorectal cancer,m CRC)患者获得长期生存的基础。但对于转移灶不可切除的Ⅳ期m CRC,其原发灶是否手术及手术时机一直存在较大争议。对于合并肠梗阻、大出血、穿孔或即将发生肠梗阻等急性并发症的Ⅳ期m CRC患者,施行急诊或限期手术处理原发灶以缓解局部症状
About 20% to 25% of patients with colorectal cancer are diagnosed with distant metastasis [1]. R0 resection of metastatic lesions and primary lesions is the basis for long-term survival of patients with metastatic colorectal cancer (mCRC) in stage IV. However, for the unresectable stage IV m CRC of metastatic lesions, whether the primary tumor has surgery or the timing of surgery has been a major controversy. For patients with stage IV mCRC with acute complications such as intestinal obstruction, massive hemorrhage, perforation or impending intestinal obstruction, emergency or limited-term surgical treatment of primary lesions to relieve local symptoms