Rectal cancer forceps after the addition of the "residual" how to do?

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Patient: my specific condition is: two OO nine years in April 5th due to an accidental hematochezia (suffering from hemorrhoids), doctors re

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Patient: my specific condition is: two OO nine years in April 5th due to an accidental hematochezia (suffering from hemorrhoids), doctors recommended colonoscopy, in April 7th of the same year to the hospital for the first time: microscopic findings: "... See... Tooth line semi annular hemorrhoid; ureteroscopy from anus 5cm see a flat mucosa uplift, about 0.4X0.4cm in size, smooth surface, color as usual, with peristalsis and gas injection did not disappear, except for more than a full clamp; rectal mucosal finishing, vascular texture clear. Pathological diagnosis: 0904335 (from Anal 5cm) rupture of chronic inflammation of the intestinal mucosa, which is a small inherent in a small amount of thin film in a slightly abnormal glands, suspected carcinoid. After seeing the above results, the surgeon thinks that if there is no myometrial invasion, it is OK to do the whole forceps. In order to find out if there was myometrial invasion? The surgeon with a device called the anus mirror like to extract from the anus disease inspection, but the doctor said at 5 cm is very smooth to extract disease inspection, so the doctor suggested to do a colonoscopy, with twenty-one (from the first electronic colonoscopy examination into the enteroscopy room, fourteen days) in the process of doing colonoscopy doctors repeatedly to 5cm from the anus check, last half hours were not unusual, because the doctor finally to work hard and patient at 5cm from the anus, see a limitation of the mucosal congestion area, about the size of 0.2 X0.3cm. (the doctor thinks it is possible to leave the first to take the mucosal congestion, but, due to suspected) pathology report first, doctors or in the mucosal congestion area except 2 tissue forceps inspection: check to see: "... See... The tooth line is about 5cm from the anal rectal hemorrhoids; see 1 limitations of mucosa congestion area, about the size of 0.2 X0.3cm, in addition to 2 pieces of tissue from forceps. Pathological diagnosis: 0905073 (from anus 5cm) carcinoid; (from anus about 20cm) intestinal mucosa chronic inflammation. My doctor said it was early detection of carcinoid tumors. Because the position is low, may not protect the anal surgery! I'm still young and the disease is early, if not surgery will lose the opportunity of early treatment; if you do not do surgery anus, and makes it difficult to accept, which caused great pressure for me, said not the anus may also cause significant impact on the quality of life, with such a choice I have anxiety dead! Here I am again begged my expert advice: 1, this situation should be how to operation, if the operation must be done radical surgery (not the anus)? 2, whether the above pathological diagnosis of myometrial invasion; the second place of the microscopic examination (mucosal hyperemia zone) is the first time in addition to infiltration or residual? 3, I can do anus preservation of local surgery? How do you do it? Ask which hospital to do. 4, now the rectum is not fast enough to pack cm 5, microscopic examination can not see any abnormalities, but from the perspective of the second pathological examination still found carcinoid". I like this situation, I heard that in good hospital equipment can be done by inspection method, the staining magnifying colonoscopy. May I ask Professor Li to have this method? If so, can you do this? Thank you Anxious to get a reply! Experts can yearn to reply, thank you!!!

Dongguan People's Hospital anorectal Li Xingqian: Hello: the incidence of colorectal cancer is very small, accounting for only 2.2% of colorectal cancer, there are essential differences with colorectal cancer. Carcinoid tumor develops slowly and is rarely transferred. At the beginning of the late can be increased to belong to benign, malignant, metastasis can occur, the histological structure similar to cancer, but unlike adenocarcinoma, so called carcinoid. Rectal carcinoid mostly in rectal mucosa, in general, the rectal mucosa is complete, only in the mirror with the forceps is difficult to get the pathological tumor tissue, found submucosal induration after most of the biopsy, with high diagnosis rate. In your case, even if the diagnosis of carcinoid, less than 1cm, is also early. However, the second pathological examination was still diagnosed as carcinoid. Suggest that you follow the doctor's treatment, surgical treatment. This excision can be, does not involve the anus; if the tumor diameter is more than 2cm, only consider radical resection (Dixon surgery or Miles surgery); tumor in 1-2cm should do local resection. For patients with partial or enlarged resection, radical surgery is performed, according to the distance between the tumor and the anal margin, sphincter function and so on. Your situation, I do not think it is necessary to do local excision can be cured, but it is necessary to review regularly after surgery. I wish you to eliminate concerns, an early recovery!

 

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