How did he achieve no fistula and protect the dignity of rectal cancer patients?

43-year-old Mr. Gao (a pseudonym) is extroverted and has a wide range of friends. He often goes hiking with friends in his spare time, and his life is very emotional. A few months ago, he was diagnosed with rectal cancer because of bloody stool. Because the focus of rectal cancer is close to the anus, the treatment plan is to remove the anus and make a permanent stoma. The anus is an important "exit" of the human body. After excision, an incision is made in the abdomen to make an artificial anus, commonly known as permanent colostomy. That is, a dung bag is hung on the abdomen, and the dung is discharged directly from the abdomen. At the thought of such a situation, Mr. Gao completely collapsed and could not accept it. But after running to many hospitals, the result is that this is a classic traditional surgical method, which has been the case for many years. Mr. Gao was in great pain and even planned to give up treatment.

Every Tuesday afternoon is the day when Professor Song Yongchun, a tumor surgeon in the First Affiliated Hospital of Xi Jiaotong University, makes a house call. The crowd was full before the opening time. Mr. Chen, 62, walked into the consulting room and spoke of his difficulties. There is a tumor in the lower part of the rectum, less than 3 cm away from the anus. Many hospitals are told that anus can't be preserved. It was hard for him to accept the thought of living by making bags in the future, and he found Dr. Song Yongchun with the last glimmer of hope.

After detailed examination, Dr. Song Yongchun found that Mr. Chen's tumor was located at a low position, but the tumor was still confined to the internal anal sphincter, and the external anal sphincter was not involved. Transanal radical resection (TaTME) for advanced rectal cancer can be used to preserve anus after radical resection. Fortunately, Mr. Gao mentioned at the beginning of the article also meets the conditions of anus preservation. The operation was very smooth and his dignity was maintained. Today, Mr. Gao not only lives like ordinary people, but also travels with friends, and his life is still free and easy. Song Yongchun's team completes nearly 100 cases of anus-preserving surgery like this every year.

Song Yongchun began to pay attention to rectal cancer from 20 10. He said that rectal cancer is a disease that can achieve a high cure rate through early surgery, but every patient who removes the anus will carry a permanent fecal bag. "Surgery to remove anus like Mr. Gao and Mr. Chen has always been resisted by patients, but in order to save their lives, most people finally accepted it passively. After the operation, many people will take the initiative to choose to be isolated from society because they are afraid of being treated differently by others. Many people will slowly move toward autism and depression. " Therefore, Song Yongchun has been paying close attention to the progress of rectal surgery at home and abroad.

Song Yongchun told reporters that rectal cancer is a geriatric disease, mostly occurring in people over 45 years old, but it has a trend of rejuvenation in recent years. Some young people in their twenties and thirties also suffer from rectal cancer, with a slightly higher proportion of men.

Rectal cancer is divided into two types: high and low. For rectal cancer whose lesion is less than 3 to 4 cm away from anus, the skin around anus and the whole anus must be dug out together with the lesion, so that the patient's anus can be turned into a hole and then stitched up to survive for a long time. This situation is the traditional radical operation of anorectal cancer.

"Fortunately, nothing is static, especially medicine. A small change in three years, a big change in five years. What I learned in college textbooks is that the lesion is more than five centimeters away from the male anus and more than three centimeters away from the female anus. If it is lower than this distance, the anus must be removed. This was the case ten years ago, but it has changed in recent years. " 20 13 Song Yongchun was excited by the new technology of rectal cancer treatment abroad (transanal total mesorectal excision). This operation can completely remove the lesion and preserve the patient's anus. The lower the lesion is from the anus, the easier it is to preserve the anus. Bottom line: the low position is no longer a problem. On the contrary, it is a problem that the lesion invades the surrounding depth, but if the lesion is deep, preoperative radiotherapy and chemotherapy can reduce the lesion with an 80% probability, and the anus can be preserved after reduction. In other words, with this new treatment technology, as long as the lesion is not too late, the anus can be preserved through surgery. In 20 15, after this technology was introduced to some hospitals such as Guangzhou and Beijing, Song Yongchun immediately went to study and introduced this treatment technology to Shaanxi. On 20 17, Song Yongchun performed the first "extreme anus-preserving operation" in Xi 'an. "In the oncology department for ten years, I have done more than 700 rectal cancer operations, and now there are nearly 100 cases every year. It is very gratifying that with transanal total mesorectal excision, it is finally unnecessary to dig out the patient's anus. " Song Yongchun is confident in the popularization and application of new technologies.

With the improvement of living standards, people's diet structure has also undergone great changes, eating richer, finer and more nutritious, but there are more and more malignant diseases in the digestive tract. According to statistics, at present, lung cancer ranks first in the incidence of tumors, followed by gastric cancer and colorectal cancer ranks third. However, the early symptoms of colorectal cancer are not obvious and are easily ignored by patients, thus delaying treatment.

"The cause of colorectal cancer is mainly related to eating habits, genetic factors and lifestyle. , especially the changes in diet structure. In cities, with the increasing intake of meat, milk and eggs in people's diet, the incidence of colorectal cancer has an increasing trend. " Song Yongchun reminded that to prevent colorectal cancer, we must first adhere to scientific physical examination, early detection and early treatment, because compared with other tumors, colorectal cancer is preventable and treatable, and 90% can be cured if found early. The second is to change eating habits, reduce the intake of high-protein and high-fat foods and refined foods, increase the proportion of vegetables, fruits and coarse grains, and maintain a balanced diet. Third, change unhealthy lifestyle, reduce smoking and excessive drinking, increase moderate exercise and avoid obesity.

Song Yongchun said: "I suggest you have a regular physical examination. Don't wait until you feel sick to go to the hospital. It is recommended that men over 40 and women over 45 have a colonoscopy every five years. If young people under the age of 40 find that the symptoms of hemorrhoids have undergone progressive changes, such as bleeding, pain, difficulty in defecation, and thinning stool, they should also pay attention to it and go to the hospital in time. "