OVERVIEW
Overview of colorectal adenomas
Colorectal adenomas are divided into three main categories: tubular adenomas, tubular villous adenomas and choriocarcinomas, of which tubular adenomas are the most common. Colorectal adenomas are closely related to colorectal cancer, and active diagnosis and treatment of colorectal adenomas is an important way to control and reduce colorectal cancer.
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Department
Gastroenterology, General Surgery
Clinical symptoms
Early stages are often asymptomatic; larger adenomas may present with blood in the stool, diarrhea, increased bowel movements (or constipation), and abdominal pain.
Hazards
It can cause intussusception and intestinal obstruction. Large adenomas are susceptible to cancer.
Complications
Intussusception, intestinal obstruction, etc.
Examination
Fecal occult blood test, rectal palpation, barium enema, proctoscopy, colonoscopy and histopathologic examination.
Diagnosis
Diagnosis is made on the basis of clinical manifestations such as blood in stool, diarrhea, and increased frequency of defecation, combined with colonoscopy and histopathological examination.
Treatment principle
Prompt treatment, most of them can be resected under enteroscopy, and those who cannot be resected under enteroscopy can be resected by surgery or minimally invasive laparoscopic surgery.
Curability
Treatment can improve and relieve symptoms, but it should be noted that adenomas can recur after removal.
Dietary advice
Food rich in vitamins, light and easy to digest is recommended. Avoid foods that are too rough and foods that are pickled, smoked or fried.
Important Reminder
After removal of the adenoma, regular follow-up and review should be conducted as prescribed by the doctor.
Causes
Etiology
The cause is unknown.
Symptoms and Diagnosis
Typical Symptoms
Symptoms of colorectal adenomas are related to their size and location. Small adenomas are often asymptomatic, while larger adenomas may present with varying degrees of blood in the stool, diarrhea, increased frequency of bowel movements (or constipation), and abdominal pain.
Diagnostic basis
1. Blood in stool, diarrhea, increased frequency of defecation (or constipation), abdominal pain, etc. 2. Rectal palpation is the easiest and most reliable method to examine rectal lesions within 7-8cm from the anus. A soft mass can be touched, and a hard nodule is a reliable indicator of adenoma cancer.3. Proctoscope, sigmoidoscopy and fiber (electronic) colonoscopy are the most reliable examination methods at present. Adenoma carcinoma under endoscopy often manifests as enlargement of tumor body, surface erosion, ulceration, necrosis-like manifestation, rigidity of the base of broad-based or short-tipped or sub-tipped adenoma, and increased fragility of adenoma tissue.
Treatment
Treatment guidelines
Colorectal adenomas are precancerous lesions and should be treated promptly upon detection. Most of the adenomas can be resected under enteroscopy, while those that cannot be resected by enteroscopy should be resected by surgery or minimally invasive laparoscopic surgery. No further treatment is needed for those without cancer in postoperative examination, while those with cancer should choose different treatments according to the depth of infiltration.
Surgical treatment
1. Enteroscopic resection can be performed by methods such as coil coagulation, biopsy forceps coagulation, electrocoagulator cauterization, etc. In the case of a pedunculated adenoma, coil coagulation is feasible. For the tip-type adenoma, coil resection is feasible. For the broad-based adenoma smaller than 0.5cm, biopsy forceps coagulation or electrocoagulator cauterization can be used, and for the broad-based adenoma of 0.5-1cm, coil coagulation can be used for resection. Endoscopic submucosal dissection (ESD) can be used for larger broad-based adenomas.2. Surgical resection can be used for choroidal broad-based adenomas with a diameter larger than 2cm, which are difficult to be resected under enteroscopy.
Prognosis
Colorectal adenomas are prone to recurrence after treatment. Regular follow-up and review should be performed as prescribed by the doctor according to the pathological type and size of the adenoma.
Nursing care
Daily care
1. Keep the environment quiet and comfortable to reduce the adverse stimulation and psychological pressure on patients. 2. Moderate and timely exercise can improve the mental outlook of patients, which is conducive to adjusting the internal function of the body and enhancing the ability to resist diseases. 3.
Dietary conditioning
Give vitamin-rich food, but should avoid too rough diet. Diet should be diversified, using more soybean products and green or orange-yellow vegetables, collard greens and fresh fruits. Do not consume pickled, smoked and fried foods.