colorectal cancer

Colorectal cancer



Colorectal cancer - it is usually adenocarcinoma (located in the colon or rectum) which develops on the basis of precancerous lesions. These lesions include: adenomas, genetic syndromes (e.g. familial polyposis), Crohn's disease, ulcerative colitis. Peak of incidence falls between 60 and 75 years of age. Predisposition to disease is inappropriate diet ( red meat, smoking, age). Keep in mind that taking nonsteroidal anti-inflammatory drugs reduces the risk of developing colorectal cancer by 50%. Another issue is Lynch syndrome (susceptibility to cancer) - there is disturbed repairing of badly paired nucleotides.


Types and symptoms


a) Cancer of the rectum and left colon - change in bowel functions, bleeding from the lower gastrointestinal tract, mucosal diarrhea. The tumor can be examined in the rectum (50-70%) during the per rectum;
b) Cancer of the right colon - abdominal pain , sneaking blood, anemia, palpable tumor of the skin layer.
Other symptoms - weight loss, fever, tympanites, intestinal obstruction.


Diagnostics


The gold standard in the diagnosis of colorectal cancer is colonoscopy with biopsy for histopathological examination. It is also used abdominal ultrasound and CT to find potential metastases. The screening tests ( women and men over 50 years old) include: testing faeces for sneaking blood (every year), fiberosigmoidoscopy (every 5 years), colonoscopy (every 10 years). In the case of increased risks (eg. after removal of polyps) performs colonoscopy every year.


Treatment


It depends on the histopathological stage of disease and its possible metastatic. The primary therapeutic method is a complete resection with leaving adequate margins and local lymph node resection. In the case of inoperable tumors of the rectum is possible earlier application radiatiotherapy to reduce tumor mass.

Postoperative treatment regimens include use of 5-fluorouracil after tumor resection in stage III (in case of rectal cancer stage II and III is used in addition radiotherapy and pelvic radiotherapy). Nonoperative cancers require chemotherapy (5-fluorouracil and folinic acid, capecitabine, oxaliplatin, cetuximab, bevacizumab). Palliative treatment (regarding stenoses) includes: stents, laser ablation, argon coagulation and stoma.

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Endoscopic Mucosal Resection (EMR) in the Management...

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Endoscopic video case: colonoscopic polypectomy plays a major role in preventing colorectal cancer. However, resection of sessile, broad-based pedunculated and flat lesions carries a high risk of perforation....

Extended Right Hemicolectomy and Left Hemicolectomy...

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Surgical video case: extended right hemicolectomy and left hemicolectomy for colorectal cancers. 

Laparoscopic Right Hemihepatectomy Caudal Approach...

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We present a case of a patient after laparoscopic sigmoidectomy (1 month ago) for colorectal cancer (T3N1c). Preoperative imaging confirmed large metastasis in posterior segments of the right lobe of...

Management of Obstructing Colorectal Cancer

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Presented by Andrew J. Russ at the "SAGES/AAST/ASCRS/SSAT Acute Care Symposium: Are you a Good Acute Care Surgeon? Improving outcomes and Reducing Hospital Mortality" session during the SAGES...

How to Collect Your Faecal Immunochemical Test...

Specialty:  Clinical Oncology
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This helpful video shows you how to complete your Faecal Immunochemical Test (FIT). FIT is a stool test designed to identify possible signs of bowel disease. It detects minimal amounts of blood and if...

Colorectal Cancer - Incidence, Screening and...

Specialty:  Clinical Oncology
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Learning objectives in the video: • Review incidence of colorectal cancer and how this is changing for the young patient. • Review of current screening techniques, their efficacy and individualization...

Should We Offer Liver Transplantation for CRLM?

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Presented by Thomas M. Fishbein at the "SAGES/ILLS Session: Multidisciplinary Modalities in the Treatment of Colorectal Liver Metastasis" session during the SAGES 2019 Annual Meeting in Baltimore,...

Endoscopic Resection of Colorectal Neoplasia:...

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Presented by Sergey V. Kantsevoy at the "The New Face of Colorectal Cancer: What Every Surgeon and Endoscopist Should Know" session during the SAGES 2019 Annual Meeting in Baltimore, MD on Saturday,...

Laparoscopic left hemicolectomy due to cancer

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A 75-year-old man suffering from sigmoid colon cancer without metastasis.

Laparoscopic Sigmoidectomy. Supracolic Splenic...

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57-year-old male patient. BMI 22.2 kg/m2 Colorectal adenocarcinoma in the sigmoid colon. He was scheduled for laparoscopic sigmoid resection. The video shows supracolic splenic flexure mobilization...