نیاز به استومی در سرطان های کولون و رکتوم

Need for ostomy in colon and rectal cancers

A stoma is a part of the intestine that is removed from the abdominal wall for some reason and fixed by sutures to the abdominal wall and excreted through the body.

 

What is ostomy

 Surgery to open the abdomen and place the stoma on the abdomen is called an ostomy.

 Need for ostomy in colon and rectal cancers (rectum and colon)

 Treatment for colon cancer or rectum is the removal of a part of the colon that has become cancerous and then two healthy parts of the colon are sewn back together, which is called anastomosis.  Colon and rectal cancer surgery may be performed under different conditions.

1- Ostomy in colon or colon cancer

 If the diagnosis is made early and the bowel can be cleansed and pre-operatively prepared, colon cancer surgery may be performed under optimal conditions and the intestinal tract removed once the two intestinal sections have been resected (anastomosis).  And the normal route of disposal is established.

 In cases where the mass is advanced and leads to intestinal obstruction or the patient has a tumor rupture, the patient is admitted to the hospital urgently and surgery is performed urgently without intestinal preparation, in which case surgery is usually performed open-ended.  It is not possible to undergo laparoscopy, and the next point is that the conditions for stitching the two intestines are usually not appropriate and the surgeon has to remove the intestine from the abdominal wall to keep the patient safe and to close the other end of the intestine.  .  This condition is called colostomy because of the risk of leakage and intestinal bleeding, and the patient has to live with an ostomy or colostomy for a while after surgery to relieve general conditions and relieve inflammatory factors and conditions.  And the two ends of the intestine are sewn together to establish a normal route of excretion.

 

2- Ostomy in rectal or rectal cancer

In the case of the rectum, the treatment is slightly different from the colon and depending on the severity of the tumor and the depth it usually requires twenty-eight sessions of radiotherapy or pelvic radiotherapy to reduce the volume of the tumor and then perform surgery.

But in the case of the rectum, emergency surgery may also be needed, in which case the abdominal wall will still resemble the abdomen and the obstruction will be resolved and the patient will then be referred for radiotherapy and after completion of the radiotherapy surgery to remove the rectum.  Is coming.

In non-emergency conditions following pelvic radiotherapy, pelvic organs are exposed to radiotherapy or radiotherapy after tumor removal and double-suture resection (anastomosis) to prevent the risk of temporary fecal leakage into the anterior part of the small intestine.  The abdomen is removed to create a deflection pathway so that the anastomosis site does not come into contact with the excretory material and the stitching and dosing is maintained. After 4 to 6 weeks, the ostomy can be resected in the abdomen with minor surgery and the normal route  Stool was established.

In the case of cancers of the lower end of the colon where the tumor is distant from the anus and the anal sphincter muscles or there is a spastic involvement with the tumor, the entire rectum along the rectum needs to be removed so the patient should have a permanent ostomy sac after surgery.  This is because it is not possible to establish a normal path to the stool.

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