Traditional surgical scar of colon cancer

The large intestine is the last part of the human digestive system. There is an ileocecal sphincter at the ileum at the end of the small intestine, where it enters the large intestine. Its function is to prevent feces from flowing back to ileum, and at the same time, it can also prevent the contents of ileum from entering the large intestine too quickly, but after passing through the sphincter of ileum, it enters the cecum, followed by the colon. The colon can be divided into four segments, including ascending colon, transverse colon, descending colon, sigmoid colon, and finally to rectum and anus. The large intestine is the end point of human digestive system. After nutrients are digested and absorbed by the small intestine, the remaining food residues, unabsorbable substances and water need to be treated in the large intestine.

The main functions of the large intestine include water reabsorption, electrolyte absorption, fecal formation and temporary storage. The rectum is the last part of the large intestine, located at the proximal end of the anus. Its function is to produce defecation and transmit it to the brain. When the amount of feces in the large intestine reaches a certain level, it will inform the brain. The anus is the sphincter at the end of rectum, which is controlled by the brain to contract or expand, and has the functions of excreting feces and controlling defecation.

Colorectal cancer can be divided into adenocarcinoma, lymphoma, squamous cell carcinoma, neuroendocrine carcinoma, gastrointestinal stromal tumor, melanoma and so on according to the different tissue sources of its primary site, among which adenocarcinoma is the majority.

Patients often have a lot of doubts when they know that they have colorectal cancer. They think they don't smoke or drink, they live and exercise regularly, they don't often eat high-fat meat or processed food, and they eat a lot of vegetables and fruits. Some patients are even vegetarian all the year round. In fact, the exact cause of colorectal cancer is still unclear in the medical field. In addition to congenital genetic factors, the environment will also affect the risk of cancer, including second-hand smoke, air pollution, diet, abnormal work and rest, stress and so on. The factors that may cause intestinal inflammation may be behind the scenes, because intestinal inflammation may cause abnormal growth of intestinal mucosal cells and increase the risk of cancer lesions.

At present, several clear risk factors in the medical field include the following.

(1) Family history: Some family members have a history of colorectal cancer.

(2) Polyposis: At present, the medical profession generally believes that polyposis is the most likely cause of colorectal cancer, and its transformation process is abnormal hyperplasia of colorectal mucosa, forming benign adenoma, and then degenerating into adenocarcinoma. Have a family history of multiple adenomas or hereditary non-multiple polyps, or polyposis caused by non-heredity.

(3) Colon inflammation: history of ulcerative colitis or Crohn.

In addition to unexplained weight loss, loss of appetite, feeling tired, nausea and vomiting, colorectal cancer also has some subtle differences due to different tumor growth sites.

1: symptoms of right colorectal cancer: less symptoms of intestinal obstruction; Mild anemia symptoms; A lump can be felt in the right lower abdomen; I often feel abdominal distension, fullness and abdominal cramps.

2. Symptoms of left colorectal cancer: it is easy to have symptoms of intestinal obstruction; Changes in defecation habits: diarrhea, watery diarrhea, constipation, or diarrhea and constipation appear alternately; Have the feeling of unclean defecation or continuous defecation; Changes in fecal characteristics: bright red and dark red bloody stools are solved, and the shape of feces is as thin as a pen.

The treatment of colorectal cancer will be evaluated according to the size, location, degree of invasion and metastasis of lymph nodes in TNM staging, including surgical treatment, chemotherapy and radiotherapy. Doctors will consider the patient's age, physical condition, treatment activity and other factors when choosing appropriate treatment methods, and then make a decision after discussing the advantages and disadvantages of various treatment methods with patients.

1: surgery

As the main treatment for colorectal cancer, the colon segment at the location of the cancer lesion and the surrounding lymph nodes are removed.

(1) Traditional surgery: open surgery, local resection or radical surgery according to the size and expansion of the tumor, suitable for patients with large tumors and deep invasion of surrounding organs.

(2) Endoscopic minimally invasive surgery: Laparoscopic surgery can reduce the pain and the appearance of the wound size, the postoperative recovery period is shorter, and you can eat and leave the hospital faster, which is suitable for patients with small tumors and no invasion of surrounding organs.

(3) Artificial anus (stoma): ① Left hemicolectomy: Most patients can do intestinal anastomosis directly, and only a few special cases will make temporary or permanent stoma, such as some patients with middle and low rectal cancer or patients with obstructive unresectable rectal cancer or sigmoid colon cancer. Most of the feces of left colostomy can be shaped, and the frequency of early defecation may increase. Regular defecation can be achieved through training and regular lavage every day.

② Right hemicolectomy: the terminal ileum, cecum, ascending colon and transverse colon are removed, and a temporary artificial anus can be set to adjust the hindgut to avoid fecal pollution, and temporary diarrhea symptoms may appear at the initial stage. After a period of time, after the doctor's evaluation, the artificial anus can be released, and it will join with the original intestinal segment.

2. Chemotherapy

Commonly known as chemotherapy, it can be divided into adjuvant chemotherapy and remission chemotherapy. That is, one or more drugs are used together for treatment, including oral or intravenous injection. Chemotherapeutic drugs are transmitted through the whole body blood to destroy cancer cells. The purpose of adjuvant chemotherapy is to reduce some cancer cells that have metastasized but cannot be detected as much as possible, which can not only reduce the probability of postoperative recurrence, but also prevent future metastasis. The purpose of palliative chemotherapy is to prolong life, relieve and improve symptoms.

3. Radiotherapy

The use of penetrating ionizing radiation to destroy the DNA of cancer cells is usually used in combination with surgery or drugs, usually for patients with rectal cancer. The tumor volume can be reduced before operation and the scope of operation can be reduced, and the local recurrence rate can be reduced after operation.

4. Targeted therapy

Molecular biotechnology can directly block the growth and repair ability of cancer cells, and kill cancer cells by using the specificity of drug targets to avoid harming normal cells. However, not every patient is suitable for targeted therapy and needs specific tumor markers to be effective. Therefore, it is necessary to discuss with the doctor what kind of treatment is more appropriate, which is usually suitable for patients in the fourth stage.