43-year-old Mr. Gao (pseudonym) is outgoing and has a wide circle of friends. He often goes hiking with friends in his spare time and has a very romantic life. A few months ago, I was diagnosed with rectal cancer due to blood in my stool. Because the rectal cancer lesions are close to the anus, the treatment plan is to remove the permanent anal stoma. The anus is an important "exit" of the human body. After removal, an opening is made in the abdomen to create an artificial anus, commonly known as a permanent fistula. That is, a fecal bag is hung on the abdomen, and stool is discharged directly from the abdomen. Thinking of such a situation, Mr. Gao completely collapsed and could not accept it. However, after visiting many hospitals, the results are all that this is a classic and traditional surgical method, which has been the case for many years. Mr. Gao was in so much pain that he even planned to give up treatment.
Every Tuesday afternoon is the day when Professor Song Yongchun, an oncology surgeon from the First Affiliated Hospital of Xi'an Jiaotong University, visits patients. Before the consultation time has come, the number of appointments is already full. Mr. Chen, 62, walked into the consulting room and expressed his difficulties. A tumor grew in the lower part of the rectum, less than 3 centimeters from the anal opening. He went to many hospitals and was told that the anus could not be preserved. It was hard for him to accept the thought of having to live with an ostomy bag in the future, so he found Dr. Song Yongchun with the last glimmer of hope.
After a detailed examination, Dr. Song Yongchun found that although Mr. Chen’s tumor was in a low position, it was still limited to the internal anal sphincter and the external anal sphincter was not involved. It can be cured radically through advanced transanal rectal cancer surgery. Surgery (also called transanal total mesorectal excision, TaTME surgery) preserves the anus in the case of radical resection. Fortunately, Mr. Gao mentioned at the beginning of the article also met the conditions for anal preservation. The surgical treatment went very smoothly and his dignity was preserved. Today, Mr. Gao not only lives the same life as ordinary people, he still gathers and travels with friends, and his life is still free and easy. Song Yongchun's team completes nearly a hundred anus-preserving surgeries like this every year.
Song Yongchun has been focusing on rectal cancer since 2010. He said rectal cancer is a disease for which early surgery can achieve a high cure rate, but every patient who has their anus dug out will carry a permanent feces bag. "Like Mr. Gao and Mr. Chen, patients have always been resistant to the operation of anal resection. However, in order to save their lives, most people finally passively accept it. After surgery, many people will actively choose to isolate themselves from society because they are worried about being 'looked at differently' by others. Many people will gradually become autistic and depressed." Therefore, Song Yongchun has been paying close attention to the progress of rectal surgery methods at home and abroad.
Song Yongchun told reporters that rectal cancer is a geriatric disease and mostly occurs in people over 45 years old. However, in recent years, it has become younger and younger. Some young people in their twenties and thirties also suffer from rectal cancer. , and the proportion of men is slightly higher.
Rectal cancer is divided into two types: high-level and low-level. For rectal cancer where the lesion is less than 3 to 4 centimeters from the anus, the skin around the anus and the entire anus must be dug out together with the lesion. The patient's anus will become A hole is then sutured and waited for it to stay. This situation is the traditional radical resection of anorectal cancer.
"Fortunately, nothing remains static, especially medicine. It really changes a little every three years and a big change every five years. What I learned from my college textbook is that the distance between the lesion and the anus is more than five centimeters for men and three centimeters for women. centimeters, if the distance is less than this distance, the anus must be dug out. This was the case ten years ago, but things have changed in recent years. "In 2013, a new technology for rectal cancer treatment appeared abroad (transanal cancer treatment). Mesorectal excision) made Song Yongchun very excited. This surgical method can completely remove the lesion while preserving the patient's anus. The lower the lesion is from the anus, the easier it is to preserve the anus. Bottom line: low position is no longer a problem. On the contrary, the depth of the lesion's invasion into the surrounding area is a problem, but if the lesion is very deep, there is an 80% probability that preoperative radiotherapy and chemotherapy can shrink the lesion, and after shrinking, the anus can be preserved. In other words, with this new treatment technology, as long as the disease is not too late, the anus can be saved through surgery. In 2015, after some hospitals in Guangzhou and Beijing launched this technology, Song Yongchun immediately went to study and introduced this treatment technology to Shaanxi. In 2017, Song Yongchun performed the first "extreme anus-preserving surgery" in Xi'an. "In the ten years in the oncology department, I have performed more than 700 rectal cancer surgeries, and now I perform nearly 100 cases every year. I am very pleased that there is now a transanal total mesorectal excision, and finally there is no need to dig out the patient's anus. "Song Yongchun is very confident in the promotion and application of new technologies.
With the improvement of living standards, people's dietary structure has also undergone great changes. They eat richer, more refined and more nutritious foods, but malignant diseases of the digestive tract are becoming more and more common. According to statistics, lung cancer currently ranks first among the cancer incidence rates, followed by gastric cancer, and colorectal cancer in third place. The early symptoms of colorectal cancer are not obvious and can easily be ignored by patients, thus delaying treatment.
"The causes of colorectal cancer are mainly related to eating habits, genetic factors, lifestyle, etc., especially closely related to changes in dietary structure. In cities, with the increase in meat, milk, and eggs in people's diet As the intake of food increases, the incidence of colorectal cancer will tend to increase." Song Yongchun reminded that the first step in preventing colorectal cancer is to adhere to scientific physical examinations, early detection and early treatment, because compared with other tumors, colorectal cancer can be prevented. Treatment, 90% of cases can be cured if detected early.
The second step is to change eating habits, reduce the intake of high-protein, high-fat foods and finely processed foods, increase the proportion of vegetables, fruits, whole grains, etc., and maintain a balanced diet. The third is to change bad lifestyles, reduce smoking and excessive drinking, increase moderate exercise, and avoid obesity.
Song Yongchun said, "It is recommended that everyone have regular physical examinations and do not wait until they feel uncomfortable before going to the hospital. It is recommended that men over 40 years old and women over 45 years old have a colonoscopy every five years. Young people under 40 years old If you find that the symptoms of hemorrhoids have progressive changes, such as bleeding, pain, difficulty in defecation, and thinning of the stool, you should also pay attention to it and go to the hospital in time.
”