Minimally invasive laparoscopic treatment of colorectal cancer

  Colorectal cancer is a common malignant tumor in China, and its incidence rate is on the rise year by year. In economically developed areas, the incidence rate of colorectal cancer has risen from the fourth place of malignant tumors to the third place after lung cancer and stomach cancer, becoming a serious threat to human life. So how to treat colon cancer?  1.Surgical treatment: The only radical treatment for colon cancer is to remove the cancer at an early stage. If metastasis is found in the investigation, but the intestinal curvature can still be free, in principle, the colon cancer should be removed to avoid intestinal obstruction in the future; on the other hand, the cancer often has erosion, blood oozing or secondary infection, so the removal can improve the general condition. For those with extensive cancer metastasis, if the diseased intestinal segment cannot be removed, palliative surgery such as fistula or shortcut should be performed.  2.Chemotherapy: After radical surgery of colon and intestinal cancer, there are still about 50% cases of recurrence and metastasis, mainly because the hidden metastases are not found before surgery or the lesions are not completely removed during surgery. Therefore, neoadjuvant chemotherapy for tumor is administered before surgery, and intra-intestinal chemotherapy for tumor in surgical treatment or enema for rectal cancer before surgery can stop the spread of cancer cells, kill and destroy cancer cells. Continuing chemotherapy after surgery has the potential to improve the 5-year survival rate after radical surgery.  3.Radiotherapy: the efficacy is not satisfactory yet. Some people believe that: ① Pre-operative radiotherapy can shrink tumor, improve resection rate, reduce regional lymphatic metastasis, intraoperative cancer cell dissemination and local recurrence; ② Post-operative radiotherapy: for cases of radical surgery, if tumor has penetrated intestinal wall, invaded local lymph nodes, lymph vessels and blood vessels, or if there is tumor remaining after surgery, but there is no distant metastasis yet, post-operative radiotherapy is appropriate; ③ Radiotherapy alone: for advanced rectal cancer cases, small dose radiotherapy can sometimes have the effect of temporary hemostasis and pain relief.  4.Cryotherapy: Cryotherapy is to use refrigerant liquid nitrogen to fully expose the tumor through anoscope, and then use cannonball type freezing head of different sizes to contact the tumor tissue, which can effectively kill and destroy the tumor tissue. It can reduce the patient’s pain, avoid making artificial anus, and obtain satisfactory effect with chemotherapy.  5.Symptomatic and supportive therapy: including analgesia and supplementary nutrition, etc. The prognosis of colorectal cancer is the best among common gastrointestinal tumors, which may be related to its biological behavior.  At present, the treatment of colorectal cancer is still mainly based on surgical resection. Whether sufficient intestinal margins, thorough lymph node dissection and whole tissue specimen removal can be achieved becomes the standard of whether the surgery achieves radical cure, and also becomes the guideline to measure whether a surgical modality is suitable to be carried out. Minimally invasive technology is the main theme of surgery in the 21st century, and minimally invasive surgery represented by laparoscopic technology is changing the pattern of diagnosis and treatment of traditional surgical diseases. With the deepening of medical understanding of human physiology and pathology and pathophysiology, giving patients the maximum psychological and physiological recovery has become the ultimate goal of surgical treatment.