《外科学》胃肠疾病 英文课件.ppt

Signetringcell*Adenoma-CarcinomaSequence**五、Spreadandmetastasis1.Metastasislymphaticsystemthemainchannel2.Invasivedirectlytoadjacentorgan3.Peritonealseeding4.Hematogenousmetastasis–liver/lungDukestaging(omitted)*六、Staging1.DukesA,B,C,D2.Chinesestagingsystem*Layersofcolonwall*Stagesusedforcoloncancer*Duke’sstaging(Disaddedlaterfordistantmetastasis)*七、Clinicalmanifestation1、Achangeinbowelhabitandbloodinstooldiarrhea/constipationalternatively-firstsymptom2、Pain–vague3、Abdominalmass4、Obstructivesymptom*5、DifferencebetweenleftandrightcolonCa-RightleftOccultbloodstool+-Anemia+-Gallbladder+-disease-like-+Brightblood-+Obstruction-+*七、Diagnosis1.Highriskgroupphysicalexam2.Occultbloodstooltest3.Bariumenema4.Fibroscopy(Colonoscopy)5.Tumormarker:CEA*Colonoscopy-Goldstandard*八、Treatmentoperation1.Endoscopicresection2.Radicalresection（1）Rightcoloncancer:righthemisectionofcolon（2）Leftcoloncancer:lefthemisectionofcolon（3）Transversecoloncancer:transversehemisection（4）Sigmoidcancer:sigmoidectomy*Righthemicolectomy,Lefthemicolectomy*Sigmoidcolectomy,Transversecolectomy*3、Coloncancerwithobstruction4、Preparationforcolectomy5、Chemotherapy,Radiotherapy6、Others*10RulestoAvoidCancer1.Don’tsmoke2.Don’tsmoke.3.Don’tsmoke.4.Avoidexposuretootherknowncarcinogens,includingaflatoxin,asbestosandUVlight.5.Enjoyahealthydiet,moderateincalories,saltandfat,andlow