[新聞] 120公斤工程師1周沒便便 竟已大腸癌三期
120公斤工程師1周沒便便 竟已大腸癌三期
台南一名體重120公斤的39歲網路工程師，平日以油炸類便當為主食，因一周未解便導致腹脹不適掛急診。奇美醫學中心發現他的大腸至少完全阻塞達8成，確診是大腸癌三期作怪。經評估患者狀況和意願，決定捨棄傳統腸造口手術裝置人工肛門，改施行跨科部的大腸支架手術，患者從進急診、手術切除到出院恢復工作僅半個月時間，目前已進行第9次化療，病情穩定恢復。
奇美一般及消化系外科主治醫師周家麟表示，臨床上許多患者排斥裝人工肛門，除因擔心產生側漏、異味等不便，還需經3次開刀和攜帶腸造口約6個月；而以身高168公分、體重120公斤的黃姓患者個案來看，肥胖BMI值高達42.5，腸造口手術要把腸道從肥厚皮下脂肪層拉出，勢必拉大手術傷口，導致傷口感染的併發症提高，因此決定改用目前尚未健保給付的大腸支架手術。
先由奇美胃腸肝膽科主治醫師謝秉欣進行約1小時的大腸支架手術，以內視鏡把腸壁撐開放入金屬記憶支架打通「隧道」，讓腸道不再堵住，當天患者即排氣解決排便問題，10天後由周家麟接手施行微創腹腔鏡手術，在腹部打開4個0.5至1公分的小洞，切除大腸腫瘤病灶，接下來除輔助性化療，並接受血液循環腫瘤細胞監測，跨科部「一條龍」式接力治療追蹤。
周家麟提醒，大腸直腸癌目前是國人癌症發生率第一名，被認為普遍與後天飲食和環境有關，而40歲以下年輕族群雖非好發年齡層，但卻易因忽略大便變細、拉肚子、腹脹等大腸癌症狀警訊，甚至把解血便當成是痔瘡出血輕忽，導致不少年輕患者確診時多已是後期，千萬不可不慎。（李恩慈／台南報導）
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