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Abstract: Uncle Chen was informed of a sigmoid nodule malignancy during a physical examination, and came for examination to confirm the diagnosis. After the CT results, the initial diagnosis was sigmoid nodal tumor, and further fecal occult blood test and molecular markers were done to clearly diagnose sigmoid nodal malignancy, and according to the results, the tumor stage was early, and surgery was performed to remove the entire sigmoid colon, part of the descending colon and part of the rectum.
Basic information】Male, 63 years old
Disease Type】Sigmoid nodal malignancy
Hospital】The First Affiliated Hospital of Kunming Medical University
Date of consultation】March 2019
Treatment plan】Surgical resection (whole sigmoid colon, part of descending colon and part of rectum)
Treatment period】2 weeks of hospitalization and review after 1 month
Treatment effect】The patient had no discomfort and her condition was initially controlled
I. Initial consultation
The 63-year-old uncle Chen came to the hospital accompanied by his daughter, who said that the patient was informed of the malignant tumor of sigmoid node during the physical examination, so he came for examination to confirm the diagnosis. The CT results showed that the asymmetric and circumferential wall thickness increased in the proximal part of the middle sigmoid colon and extended to the peri-colonic fat, which was initially diagnosed as sigmoid nodal tumor. The results clearly diagnosed sigmoid nodule malignancy. The patient and family were told that according to the results, the staging was early and prompt surgery was needed, and postoperative chemotherapy was advocated as adjuvant therapy to reduce the chance of recurrence and improve the survival rate. The patient and his family agreed to the treatment plan.
II. Treatment history
After admission, the patient was scheduled for surgery. Under anesthesia and sterilization, an incision was made in the abdomen next to the rectus abdominis muscle, the skin and subcutaneous fat were incised, the pelvis and other internal organs were explored for metastases, then the sigmoid node was lifted, the vessels at the root of the sigmoid node mesentery were exposed, ligated, and the entire sigmoid colon, part of the descending colon and part of the rectum were removed, and anastomosis of the colon and rectum was performed. The pelvic cavity was flushed with saline, and a drainage tube was placed, and the incision was sutured.
III. Treatment effect
Because the surgery of sigmoid nodule malignant tumor is a relatively large surgery and the patient is old, the recovery time will be slow, so we have to wait for 2-3 months until the patient’s body fully recovers and then carry out adjuvant chemotherapy treatment to avoid the side effects brought by chemotherapy that the body cannot bear. Since the patient’s condition was discovered in time, the staging was early, no metastasis appeared, and the surgery was extended to remove the whole sigmoid colon, so the patient recovered well after surgery and was discharged from the hospital at 2 weeks. The patient was asked to review her health condition after 1 month to determine when to administer adjuvant chemotherapy to reduce the recurrence rate.
IV. Notes
We are glad that the patient’s symptoms have improved after treatment, but in daily life the patient still needs to pay attention to some matters.
1, the patient’s postoperative diet should be gradually transitioned from a liquid diet, to a semi-liquid diet, and then gradually back to a normal diet to ensure nutritional needs, and can consume more millet porridge, rice porridge, lotus root soup, egg custard, tofu brain, etc., and drug nutritional support when necessary.
2. For patients who need to be bedridden, family members should massage and turn the patients on time to keep their bodies clean and dry to prevent bedsores from occurring.
Family members should give more care and comfort to the patients to help them improve their confidence and face the disease treatment positively.
V. Personal insight
Through the understanding of the case, timely physical examination can effectively prevent the occurrence of major diseases, just like the patient’s timely detection, early staging and timely treatment of the disease, which greatly helps the treatment effect and improves their own survival rate. At the same time, patients with sigmoid colon cancer should have long-term review after surgery to prevent tumor metastasis or recurrence. Patients should pay attention to rest, keep sufficient sleep, maintain sufficient energy in the body, and exercise appropriately to enhance the body immunity, which has a positive effect on the recovery of the disease.