2023-06-09 02:00:00
Reported by Health and Medical Network/Reporter Zheng Yifen
Colorectal cancer has ranked first among the top ten cancers for 15 years, and most patients are shocked when they hear that they will have a stoma (artificial anus)! Fortunately, medical technology is changing with each passing day. You Zhengfu, chief physician of Chang Gung Colorectal and Anal Surgery in Linkou, said that many cases choose Da Vinci robotic arm minimally invasive surgery for fear of stoma. According to clinical statistics, only 1% of patients need permanent stoma. mouth, and it will be paid through health insurance starting March 1 this year, and it is estimated that as many as 3,000 patients in Taiwan will benefit in one year.
▲Dr. You Zhengfu called for diversification of treatment for rectal cancer. The public follows the doctor’s advice. After surgery, they can have a good prognosis and restore ideal intestinal function.
What are the different treatment strategies for the colorectum?
Colorectal cancer treatment methods include surgery, radiation therapy (commonly known as electrotherapy), chemotherapy, targeted drugs, immune cell therapy, etc. Due to their different structures and physiological functions, the two have slightly different treatment procedures.
- Colorectal cancer:Also known as colon cancer, as long as the patient is not in the fourth stage, surgery is recommended to be given priority, and postoperative chemotherapy can be combined with targeted adjuvant therapy according to the situation.
- rectal cancer:Patients with middle and low rectal cancer can receive radiotherapy and chemotherapy first to shrink the tumor before surgery, which can reduce the local recurrence rate and increase the chance of retaining the anus. Chemotherapy may be assisted according to the situation following operation.
The “ostomy” that everyone has heard regarding is to place the opening of the intestines in the abdomen, instead of the anus to discharge the excrement in the intestines. Dr. You Zhengfu explained that patients with rectal cancer usually need to have a stoma. In the early years, many patients thought that “stool comes out of the stomach” and lost their self-esteem. They would rather give up treatment than have a stoma. There are two types of stomas: temporary and permanent.
- Permanent stoma:If the tumor invades the anal sphincter, a permanent stoma must be made.
- Temporary stoma:Patients with low rectal cancer undergo radiotherapy and chemotherapy before surgery. If the tumor shrinks, there is a chance to keep the anus, and a temporary stoma is enough; or for those with a high risk of intestinal anastomosis, a temporary stoma is also recommended. After 3-6 months, the intestinal wound has healed, and the anus can be connected back through surgery.
The size of the pelvic cavity in men and women affects surgery Minimally invasive surgery helps protect the anus
- Traditional laparotomy:There are health insurance benefits. The larger the wound, the longer the postoperative recovery period. Attention should be paid to fecal leakage to avoid peritonitis.
- Laparoscopic surgery:The wound, bleeding volume and pain are all smaller than traditional laparotomy.
- Da Vinci robotic arm minimally invasive surgery:The wound is the smallest, the intestinal anastomosis is good, and the postoperative recovery is faster.
Surgical management of rectal cancer is limited to the pelvic cavity, so it is difficult for larger bowel cancers. In particular, the male pelvic cavity is narrower than that of females, and the space available for laparoscopic surgery is relatively narrow, and it is difficult to reach the bottom, and the anastomosis is not easy. Dr. You Zhengfu said that today’s new Da Vinci minimally invasive surgery has clear images, and the robotic arm is stable and flexible. It can be operated in a small space, and it will not damage the patient’s nerves and blood vessels, which helps to preserve urination and sexual function. On the first day following the operation, the urinary catheter can be almost removed and the patient can get out of bed.
A patient with middle and low rectal cancer was originally unwilling to have a stoma and planned to give up the operation. After discussion, he decided to undergo minimally invasive surgery with the Da Vinci robotic arm. Unexpectedly, he might get out of bed the next day and go home in three days. The overall course of treatment was completed in only 1 week; the other case originally required a stoma. Before the operation, radiotherapy and chemotherapy were performed to shrink the tumor, and then a minimally invasive operation with the Da Vinci robot arm was used to enter through the anus. The lesion was removed and sutured. The entire operation was completed in only 1 hour, and the postoperative recovery was good.
Starting from March 1 this year, the Da Vinci operation will be used in the “low anterior rectal resection” under the insurance coverage. Dr. You Zhengfu appealed that there are quite a variety of weapons for the treatment of rectal cancer nowadays. As long as people follow the doctor’s orders for treatment and use Yilexi treatment following surgery, they can have a good prognosis and restore ideal intestinal function.
source:
healthnews.com.tw
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