"Beware of hemorrhoids" assassin "
About a year ago, an old man walked into the anorectal clinic of the First Affiliated Hospital of Tsinghua University, who was almost 70 years old, in good spirits and with a loud voice. Before I could ask for a consultation, the old man said, "I've had hemorrhoids for decades, and I've been so uncomfortable lately that I can't relieve my stool." Doctor, you can find a way to get rid of the hemorrhoids! The family members who accompanied him also said that they had taken a lot of hemorrhoid suppositories and hemorrhoids cream at the clinic, but the effect was not good, and the bleeding had increased recently. This time, the old man made up his mind that he must have hemorrhoid surgery. After I learned about the medical history, I examined the old man, and it was true that annular mixed hemorrhoidal prolapse could be seen around the anus, accompanied by mucosal valgus, but the finger examination was about 4cm away from the anal margin and the rectum could be palpated with a pericular mass, which was hard and fixed, with a narrow intestinal lumen and blood-stained finger sleeves. Kind words comforted the patient to wait outside the door, leaving the family members behind, and informing them that the patient did have more serious hemorrhoids, but what was more serious was that there may be malignant tumors in the rectum, that is, rectal cancer, which needed further examination. Although the family members were shocked, they quickly understood and cooperated with the inspection.
Soon CT, MRI and colonoscopy were completed, and pathology also confirmed differentiated adenocarcinoma in the rectum, fortunately no distant metastasis was found, but the tumor was too close to the anal margin, and it was difficult to preserve the anus. After multidisciplinary consultation (MDT), it was decided to proceed with neoadjuvant chemoradiotherapy. The treatment process was smooth, and although bone marrow suppression and perianal skin radiation injury occurred during this period, the symptomatic treatment was successfully relieved. The patient's symptoms of poor defecation also gradually disappeared. Ten weeks after the end of radiotherapy, the tumor was assessed to have significant regression, a small amount of scar remained at the original rectal tumor, and the lower edge was about 5 cm from the anal margin. After adequate preoperative preparation, elective radical rectal cancer was performed, and a small bowel protective ostomy was performed at the same time. 3 months after the operation, the patient's condition was re-evaluated and the patient was re-evaluated, and the small enterostomy was readmitted and mixed hemorrhoidal external stripping and internal ligation were performed. At this point, the patient completed the full course of treatment, saved the anus, and cured the disease. During the follow-up, the patient had good bowel control and returned to a healthy old age.
Hemorrhoids are a common disease, and everyone will have some symptoms to a greater or lesser extent, and most of them do not require surgical treatment. However, if the symptoms of hemorrhoids change, accompanied by other discomforts, such as weight loss, persistent bleeding, difficulty in defecation, changes in the shape of the stool, discomfort of anal swelling, etc., you should seek medical attention in time, even if you do a basic digital anal examination, most rectal cancers can be found, and if necessary, fiberoptic colonoscopy can be done. Don't think you have old hemorrhoids, use medicine to solve them at will, and be wary of hemorrhoids "assassin" - rectal cancer.
Ultra-low rectal cancer has always been a difficulty in the treatment of colorectal tumors because of the difficulty of surgery and the difficulty of preserving the anus. "Wear a fecal pocket after surgery", this is the eternal knot of every rectal cancer patient; And increasing the anus-preserving rate is the obsession of every colorectal doctor. Under the leadership of Chief Physician Zhao Li, the Department of General Surgery of our hospital closely followed the international advanced treatment concept and combined with the advanced radiotherapy equipment of our hospital, and put forward the concept of functional anus preservation. The core of functional anal preservation is not only to preserve the shape of the anus, but also to retain the normal function of the anus. In the past 5 years, the anus-preserving rate of ultra-low rectal cancer in the department has exceeded 90%, and the patients have good bowel control function, which is in the forefront of the country.
So, what if it's too late and there's a transfer? Let's listen to the next breakdown.
Introduction of Physicians of Colorectal Group and Anorectal Professional Group of General Surgery:
Li Zhao, Ph.D. in Surgery, Chief Physician, graduated from Peking University Health Science Center. He has been engaged in general surgery for more than 20 years, and is currently the director of the Department of General Surgery of the First Affiliated Hospital of Tsinghua University, and has accumulated rich experience in the diagnosis and treatment of general surgical diseases. He was a visiting scholar at the Johns Hopkins Hospital Cancer Center, and has deep attainments in the comprehensive treatment of gastrointestinal and colorectal tumors. At present, he is a member of the MDT Special Committee of the Colorectal Tumor Professional Committee of the Chinese Medical Doctor Association, a youth member of the Surgical Skills Expert Committee of the Beijing Medical Doctor Association, a member of the Hepatobiliary and Pancreatic Surgery Professional Committee of the Chinese Medical Education Association, a member of the Abdominal Tumor Professional Committee of the Chinese Medical Education Association, a member of the Intelligent Medicine Professional Committee of the Chinese Research Hospital Association, a member of the Tumor Accelerated Recovery Surgery Special Committee of the Beijing Anti-Cancer Association, and a member of the Standing Committee of the Thyroid Cancer Professional Committee of the Beijing Cancer Prevention and Control Society. Member of the Special Committee for Precision Treatment of Digestive Tract Tumors of Beijing Cancer Prevention and Control Association. As the first author, he has published more than 20 papers in domestic and foreign journals and 6 SCI papers.
Professional expertise: laparoscopic minimally invasive surgery for colorectal cancer; Comprehensive treatment of colorectal cancer liver metastases; Anus-preserving for ultra-low rectal cancer; Surgical treatment of anorectal diseases.
Visiting hours: Every Monday morning at the specialist clinic
Qin Chunhe, deputy chief physician, is good at the diagnosis and treatment of various anorectal diseases, and has completed more than 10,000 cases of mixed hemorrhoidal PPH surgery, mixed hemorrhoidal external stripping and internal ligation, transanoscopic hemorrhoidal banding, anal fistula resection and other surgeries; He is good at the diagnosis and treatment of gastrointestinal tumors, including laparoscopic radical resection of ultra-low rectal cancer (anal preservation), diagnosis and treatment of metastatic colorectal cancer, etc., and has rich clinical experience.
Professional expertise: diagnosis and treatment of perianal diseases; Minimally invasive surgical treatment of colorectal cancer.
House call time: Monday morning, Wednesday afternoon anorectal clinic.
Hou Dingding, the attending physician, is good at the diagnosis and treatment of perianal diseases, and is proficient in carrying out common perianal diseases such as mixed hemorrhoidal external stripping and internal ligation, internal ligation and ligation, external hemorrhoidectomy, perianal abscess incision and drainage, anal fistula resection, anal fissure resection, etc., which are well received by the majority of patients.
Professional expertise: diagnosis and treatment of perianal diseases.
House Hours: Monday afternoon anorectal clinic.
Author: Department of General Surgery, First Affiliated Hospital of Tsinghua University