Zhu Jianwei rectal cancer anal surgery can not be at the expense of life at the expense of Sohu heal-verbal jint

Zhu Jianwei: rectal cancer anus preserving surgery can not be published at the expense of the Sohu at the expense of health life: Zhu Jianwei, chief physician, professor and doctoral tutor, deputy director of the Hospital Affiliated to Nantong University, director of gastrointestinal surgery and Department of general surgery. There is a male patient with rectal cancer, tumors located in the anal edge, tumor and the range of half of a colonoscopy bowel, directly report anal cancer, cell types reported no tumors, no infiltration of the imaging reports, no rapid intraoperative frozen hospital conditions, the doctor gave him first in charge of anus preserving rectal cancer surgery the reason is that family members urged the retention of anus. The problem with such treatment after surgery is how to ensure that there is no residual tumor cells at the distal edge of the rectum How to ensure that the so-called anal sphincter can also play a role? Postoperative pathology if prompted a high degree of malignant cells, vascular invasion of how to do the next step of treatment? The next step is how to deal with local recurrence and metastasis of the anus to be retained With the development of laparoscopic technique, double stapling technique in rectal cancer, anal preservation rate increased obviously than it was a few years ago, this increase also benefited from other aspects including preoperative staging and pathological analysis of technology progress and the chemotherapy and adjuvant treatment follow up! However, despite this, the probability of local recurrence of rectal cancer at a high level, the reason mainly lies in the patient and the doctor for surgery is the first element of the concept has not fully understood, only a complete radical operation will lay the foundation for postoperative adjuvant therapy, can remain unchanged, even if the pathological analysis of postoperative malignant degree is what can be done, the doctor can have a clear conscience. The decision to keep the anus easily is a reckless and irresponsible act, and the result will be the cost of the patient’s life. From the comparison at home and abroad, why China’s 5 year survival rate of colorectal cancer is lower than in Europe and the United States, surgery is an important reason! Ask some doctors to know what is the meaning of rectal resection? Why do you have a column resection? Why is the development of low anal sphincter technology so good today to carry out such a APR operation? In a word, the scope of resection, radical cure can try to ensure that the problem! So far, there are still some doctors believe that the anus is only based on the distance between the tumor and the anus. This is a lazy, not thinking of performance. Whether to retain the anus is a very very careful research questions, in the discussion before the operation, need careful explanation and description, according to the law of tort liability requirements, to make analysis and explanation to the serious patient or patient representative. It is often the case that there is an argument for the presence of an extra low anal sphincter, especially in the case of an argument, but I must follow the principle that the distance between the tumor and the margin is sufficient Generally need 2cm distance, it was also a distance of 1 cm, but need to have enough grasp. If it is a highly malignant mucinous adenocarcinoma, the distal end requires a 5cm distance. In order to ensure that there are no cancer cells in the distal margin of the tumor, the circumferential margin of the tumor is sufficient相关的主题文章: