2021年2月17日星期三

hemorrhoids and anal fissures,Ultra-low rectal cancer, early diagnosis and treatment can protect the anus

    In order to treat his father and keep the anus, Mr. Zeng, who lives in Suzhou, has not been bothered recently. It turned out that Mr. Zeng’s father was 60 years old this year. He had a colonoscopy at a local hospital because of repeated blood in the stool and changes in his stool habits. As a result, he found "low rectal cancer". After consulting with many hospitals, he was told that he wanted to be treated. , It is necessary to radically remove the tumor and cut (excavate) the anus, which is bad for the father and son.

    Rectal cancer is not easy to cut the tumor and protect the anus

    After going back and forth, Mr. Zeng found Wang Zhigang, the director of General Surgery of Shanghai Sixth People's Hospital. After seeing the patient’s colonoscopy report and performing anal finger examination, Wang Zhigang informed the patient and his family that the lower edge of the tumor was about 4cm from the anus. It was an ultra-low rectal cancer, which was still early, but it was very low. Treatment, but very difficult. Director Wang Zhigang suggested that the latest endoscopic incision-free radical resection of rectal cancer can be used to try ultra-low anus-preserving surgery for rectal cancer.

    On the afternoon of December 1, with the assistance of the Department of Anesthesiology, Director Wang Zhigang performed an operation on Mr. Zeng's father. After intraoperative exploration, the patient's condition basically confirmed the preoperative judgment. The lower edge of the cancer was about 4cm from the anus, which was an ultra-low rectal cancer.

    Under the leadership of Director Wang Zhigang, the surgical team completed a total mesangial resection of rectal cancer, completely resecting the mesorectum where the tumor and related lymphatic drainage are located. The tumor specimens were taken out through anorectal turnover by director Wang Zhigang through a series of endoscopic operations, and accurately positioned and removed under visual inspection. In this way, it not only ensures that the tumor is completely resected without residue, but also preserves the anal function, and also achieves no incision in the abdominal wall.

    After more than 3 hours of minimally invasive surgery, Mr. Zeng's father successfully got rid of the problem of rectal cancer and saved his anus. Old Zeng, who is in a good mood, recovered quickly. He could go to the ground on the first day, eat liquid on the second day, have bowel movements on the fourth day after surgery, and have good anal bowel control. The postoperative pathology report showed that the old one had suffered from rectal cancer, which was very dangerous.

    The incidence of rectal cancer remains high in Shanghai

    According to Director Wang, in the past two decades, due to the westernization of diet and lifestyle, the incidence of colorectal cancer in Eastern countries such as China and Japan has tended to increase. Most studies believe that the reasons for the increasing incidence of colorectal cancer are related to lifestyle changes such as high-fat diet and insufficient exercise. The proportion of rectal cancer in colorectal cancer in China is higher than that in the West, and the proportion of low and medium rectal cancer is also higher than that in the West. The incidence of colorectal cancer in descending order is rectum, sigmoid colon, cecum, ascending colon, descending colon and transverse colon. The ratio is 1.65:1.

    Anus preservation surgery for low and ultra-low rectal cancer has always been the focus of attention of surgeons and patients. If these patients with early stage and well-differentiated low- and ultra-low rectal cancer undergo ostomy surgery according to traditional judgments, the change in the patient’s defecation channel will seriously affect the quality of life, and the endoscopic non-incision technology will treat endoscopic colorectal cancer surgery Features such as minimally invasive and functional protection have been brought into full play. Compared with traditional surgery, this surgical method can turn the cancer out of the anus and accurately locate the margin under direct vision, which can better preserve the anal function, has a good radical cure effect, ideal minimally invasive effect, and faster postoperative recovery , No incision pain after operation, short hospital stay, low cost and other advantages.

    Undoubtedly, this has brought good news to patients with low rectal cancer detected early.

    Experts call for early detection and early treatment of people over 40 years of age can be screened

    Among the colorectal cancer patients treated by Director Wang Zhigang, there were many patients who only had blood in their stools in the early stage, but they delayed the diagnosis and treatment of hemorrhoids for one or two years. For people with high-risk factors, experts call for special attention to colorectal examinations: for example: 1) already suffering from colorectal polyps; 2) family hereditary polyps and polyposis; 3) inflammatory bowel disease: including ulcerative colitis and Crowe En disease; 4) After cholecystectomy; 5) Those with a family history of colorectal cancer.

    Japan, Germany, and the United States have all enacted legislation requiring citizens over the age of 50 to receive a colorectal cancer screening every year; colorectal cancer accounts for 23.7% of young Chinese cancer patients. The follow-up and research results of young colorectal cancer patients conducted by Director Wang show that young patients have high malignant tumors and poor prognosis, so early detection is crucial.

    At present, the general screening of colorectal cancer is generally performed by fecal occult blood test twice, and those with a positive reaction are further subjected to colonoscopy.

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