Treatment of colon cancer - quick. At the same time remove the affected portion of colon tumors with regional metastases. After removal of the tumor restores the integrity of the intestine through the creation of the anastomosis between them - that is, cross-linking.
Basic requirements for the surgical treatment of tumors of the colon:
Radicalism,
Ablastics,
Aseptic,
Restoration of the passage of intestinal contents.
It is important to note that the results of surgical treatment of colon cancer depends to a great extent on how the patient is prepared for surgery.
Preparation for surgery on the colon is to completely clear the contents of the intestine, thereby minimizing the risk of infection in the area of the anastomosis and prevent its complications such as failure of the anastomosis. This is usually appointed without slag diet, cleansing enemas, and laxatives within 5 days before surgery. Today, more and more often to clean the intestines before surgery resorted to orthograde flushing of the gastrointestinal tract.
Ablastics - is the principle of surgical interventions in cancer pathology, when the doctor tries to avoid the manipulation of the immediate area of the tumor, and early ligation of the blood vessels feeding the tumor. This is all done in order to reduce the possible risk that the migration of cancer cells during surgery for other tissues and organs of the abdominal cavity.
The radicalism of the operation - the principle of interference in such volume that ensures the complete removal of both the cancer and the metastasis of her.
In the case where the patient has already distant metastases (IV stage of cancer), even with complete removal of the cancer with regional metastases, radicality of this operation is questionable, because the cancer cells still remain in the body.
Surgical treatment may also be palliative, that is not conducted with the aim of radical tumor removal, but in order to facilitate the patient's condition. Usually in this case, if you can not remove the tumor (eg, germination her vital organs and tissues), it remains in place, and out through the colon to the abdominal wall colostomy.
In terms of volume of surgery for colon cancer can be divided into typical, combined, extended and combined.
The volume of typical operations for colon cancer is to remove the tumor in accordance with this stage and its localization. For example, at a certain stage of the cancer resection is carried out part of the intestine, while another is already higher - removing half of the colon (hemicolectomy).
When combined interventions in addition be subject to removal of the colon and other organs (or part thereof), if the tumor grows into them.
Extended resections carried out over the proliferation of colon cancer or the presence of other tumors.
In combined operations, along with resection of the colon performed removal and other bodies regarding comorbidities (eg, gall bladder, ovary).
It should be noted that the cancer treatment today involves a comprehensive approach. That is, in addition to the operations are conducted, and such treatments as radiation therapy and chemotherapy, as only the combination of these methods is able to completely remove most of the body the cancer cells.
Surgical treatment of colon cancer
The volume of surgery for cancer of the colon depends on the stage and extent of tumor spread. In some cases, the surgeon may be limited to resection of the sigmoid colon (distal colon), while others have to remove almost the entire colon (subtotal resection).
Among the operations on the colon for cancer of the following:
resection of the distal sigmoid colon,
segmental resection of the sigmoid colon,
left-sided hemicolectomy,
resection of the transverse colon,
right-sided hemicolectomy,
subtotal resection of the colon.
Extended operations are conducted in case of detection of metastases in regional lymph nodes during surgery.
After resection of the colon free ends of the intestine unite with each other - forming anastomosis. To do this, it is important to respect the three conditions are met: adequate preparation of the colon, the absence of tension knots in place of the formation of the anastomosis and a good blood supply to the bowel wall at the site where the surgeon wants to sew.
The formation of the anastomosis is carried out either conventional surgical suture or mechanical joints.
When surgery for colon cancer is carried out urgently, such as acute intestinal obstruction, the intervention is carried out in two stages. This is due to the fact that a colon in these cases, of course, unprepared, and doing the usual operation is necessarily accompanied by failure of the anastomosis. In other words, the link is just a gut "falling apart", which leads to contamination and infection of the abdominal cavity, and this, in turn, is fraught with peritonitis. Usually at the first stage is carried out to remove the tumor and the colon is displayed on the abdominal wall - TN colostomy is created.
In the second stage, which takes place a few months later, the formation of the anastomosis is carried out (on average 2-5 months).
Surgical treatment of rectal cancer
Surgery for rectal cancer depends on how far the tumor is located on the anus. When the location of the tumor is less than 7 cm from the anus, the choice is made in favor of the extirpation of the rectum. It involves the removal of both the rectum and its sphincter system.
If the tumor is located on 7 cm from the anus, is carried out either abdomino-anal resection of the rectum, with the place of the anus is reduced sigmoid colon, or anterior resection of the rectum.
Combined and complex treatment of colon cancer
As already mentioned, in the treatment of cancer, the principle of integrated treatment. It consists in carrying out all three treatments: surgery, radiotherapy and chemotherapy.
Usually carried out radiotherapy before surgery, to destroy tumor cells and thereby reduce its volume, which facilitates the operation.
Prediction of colon cancer
The prognosis of colon cancer depends on the stage of cancer. In the initial stages of tumor 5-year survival rate can reach 90%. The higher the stage of cancer, the worse the further prognosis of the disease. With the defeat of cancer of the lymph nodes of 5-year survival is usually less than 50%.
For rectal cancer prognosis worse.
What is important is prevention of colon cancer. To do this, individuals must be regularly operated to carry out a survey on the detection of cancer recurrence. It is important to control the character of the stools, the presence of impurities.
Every 3 months or sigmoidoscopy performed colonoscopy. Should not be neglected and so the simplest method of diagnosis, as the digital rectal examination. Every six months, performed ultrasound of internal organs to detect distant metastases.
Up to 85% of cancer recurrences is detected during the first two years after surgery.
