MindMap Gallery Colorectal Disease(1)
Colorectal diseases - mind map of rectal cancer. Its clinical manifestations include blood in the stool > frequent stool > thin stool, symptoms of rectal irritation, ulceration and bleeding of cancer, symptoms of intestinal stenosis, and symptoms of invasion of other tissues.
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This is a mind map about plant asexual reproduction, and its main contents include: concept, spore reproduction, vegetative reproduction, tissue culture, and buds. The summary is comprehensive and meticulous, suitable as review materials.
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colorectal disease
rectal cancer
Anatomy
About 12-15cm long, the lower part expands into the rectal ampulla
Bounded by peritoneal reentry
Upper rectum (interperitoneal position)
Lower rectum (extraperitoneal position)
Male (in front are the bladder base, ureters, vas deferens, seminal vesicles, and prostate)
Female (with posterior vaginal wall in front)
Distance from dentate line
5cm (lower)
10cm(medium)
15cm (top)
The junction with the anal canal
Anal column (longitudinal folds of mucosa)
Anal valve (the fold between the base of the anal column)
dentate line
The edge of the anal valve and the lower end of the anal column form
anorectal muscles
internal sphincter
involuntary muscles
external sphincter
Voluntary muscles (divided into subcutaneous, superficial and deep parts)
anorectal ring
Accidental complete cutting may result in fecal incontinence.
Incidence>Colon cancer, low rectal cancer is more common
transfer
Lymphatic transfer is the main route
direct infiltration
Deep invasion and growth earlier than vertical axis invasion
The vast majority of rectal cancers invade distally ≤2cm
clinical manifestations
Blood in the stool > Frequent stool > Thin stool
Rectal irritation symptoms
Frequent defecation, change in defecation habits, tenesmus, and feeling of incomplete defecation
Cancer rupture and bleeding
Blood and mucus in stool
Symptoms of intestinal stenosis
Progressive thinning of stool
Symptoms of invasion of other tissues
Diagnosis and examination
digital rectal examination
The most important physical examination for low rectal cancer
laboratory tests
fecal occult blood
Tumor marker CEA
Assess tumor burden and monitor postoperative recurrence
endoscopy
Film degree exam
Pelvic contrast-enhanced MRI
Assess the depth of tumor invasion, whether lymph nodes have metastasized, and whether fascia is involved
Enhanced CT of chest, abdomen and pelvis
Liver and lung metastasis
Clinical stage
I
II
III
IV
treat
Surgery (main method)
Tumor location guides surgical approach, Patients with resectable liver, lung or inguinal lymph node metastasis can be resected and dissected at the same time
local excision
Within T1
At least 3mm margin
radical resection
Miles surgery (abdominoperineal resection)
Permanent single-lumen sigmoid colostomy in the left lower quadrant
Especially suitable for low rectal cancer that cannot preserve the anus
Dixon surgery (low anterior resection)
Preserve anus
The distal distance of the tumor is required to be ≥2cm from the resection margin, and for low rectal cancer, it is required to be ≥1cm.
Suitable for: The external anal sphincter and levator ani muscle are not involved, and the circumferential resection margin is guaranteed to be negative.
Hartmann operation
Transabdominal resection of rectal cancer Proximal stoma Distal closure
Suitable for: Poor general condition, unable to endure Miles Dixon is not suitable for acute obstruction