As surgery remains the cornerstone of colorectal cancer (CRC) treatment, the number of older patients presented for colorectal resection is rapidly increasing. Nevertheless, the choice to operate an oldest-old patient still remain challenging and requires a careful assessment of risk to benefit ratio in order to guarantee appropriate surgical strategies and perioperative management. A centenarian patient, acutely admitted to the emergency department, was diagnosed with an ileus caused by stenosing ascending colon cancer with abnormal distension of the right colon at high risk of perforation. Facing with this complex clinical scenario, a lateral decompressive cecostomy as alternative surgical procedure, was performed in local anesthesia in order to avoid the stressful event of an emergency surgery. Thereafter, the patient was admitted to the surgical ward and followed by a geriatrician who performed a comprehensive geriatric assessment (CGA) and daily clinical evaluations. This integrated plan of care was mainly focused on rehabilitation, nutritional interventions and therapeutic reconciliation, maximizing patient’s clinical conditions and performance status. Then, the second surgical step, the radical colon surgery with curative intent and bowel continuity reestablishment was performed, demonstrating to be feasible and safety also in a very advanced age patient in term of prolonged survival and preservation of an adequate quality of life. This is the first case-report that illustrates a successful two step surgery for CRC in a centenarian patient thanks to a multidisciplinary based approach, overwhelming the mere concept of chronological age.

中文翻译：

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对患有急性结肠癌的百岁老人患者进行两步手术和多学科治疗。

由于手术仍是结直肠癌（CRC）治疗的基石，因此接受结直肠切除术的老年患者数量正在迅速增加。尽管如此，选择手术年龄最大的患者仍然具有挑战性，需要仔细评估风险收益比，以确保采取适当的手术策略和围手术期管理。一名急诊入急诊室的百岁老人患者被诊断为肠梗阻，原因是狭窄的升结肠癌伴右结肠异常扩张，穿孔风险很高。面对这种复杂的临床情况，在局部麻醉中进行了外侧减压头颅切开术作为替代性手术，以避免紧急手术的压力事件。之后，该患者被送往外科病房，随后由一名老年医师进行了全面的老年评估（CGA）和日常临床评估。该综合护理计划主要侧重于康复，营养干预和治疗和解，最大限度地提高患者的临床状况和表现状态。然后，进行第二个手术步骤，即进行根治性结肠癌根治术并重新建立肠道连续性，这在高龄患者的长期生存和维持适当生活质量方面也证明是可行和安全的。这是第一个病例报告，这说明了由于采用了多学科的方法，百岁老人患者成功进行了两步式CRC手术，使单纯的按时间顺序排列的概念不胜枚举。