Why should we insist on post-operative review?
With the continuous progress of medicine, the treatment of GI malignant tumors has developed from a single radiotherapy or surgery to a comprehensive system. For patients who have undergone surgical treatment, adhering to standardized postoperative observation and review is also a very important and indispensable part of the tumor treatment process. Regular and standardized postoperative review plays an important role in the treatment of disease.
1. To assess the possible side effects of treatment.
Since the surgery of GI malignancy usually needs to change the structure of GI tract itself (such as subtotal resection of stomach or colostomy after colorectal cancer surgery), patients may have GI symptoms such as bloating, diarrhea, abdominal pain and even some systemic symptoms after surgery. The causes behind these seemingly identical discomfort symptoms may be different. For example, in the case of bloating, some patients may suffer from functional disorders due to rapid eating, while some patients may suffer from organic changes due to intestinal obstruction caused by postoperative intra-abdominal adhesions. In addition, some patients require adjuvant therapy such as radiotherapy, chemotherapy and immunotherapy after surgery, and these treatments may be accompanied by mild or severe complications. Therefore, in order to comprehensively assess the postoperative recovery of patients and to be able to receive timely treatment of the disease, it is recommended that patients be reviewed regularly and regularly.
2. Early detection of recurrent foci with the possibility of resection and cure, or diagnosis of new heterochronous tumors when infiltration has not occurred.
In patients with progressive and certain early stage gastrointestinal malignancies, despite radical surgery, some patients still have recurrence and metastasis after surgery. And regular postoperative comprehensive review and follow-up can help patients to detect new lesions in time. Studies have proved that if new lesions can be detected early and excised completely, it does not affect the expected survival of patients after surgery.
3.Avoid unnecessary doubts.
Many patients with gastrointestinal malignancy will have various doubts after surgery. Compared with various sources, the guidance obtained from regular hospitals and doctors is more informative and more in line with the principle of individualized treatment.
Time and content of postoperative review
There is evidence that postoperative recurrence in patients with gastrointestinal malignancies mostly occurs within the first 1-3 years after surgery, therefore, patients should be reviewed relatively frequently within the first 3 years after surgery, and after 3 years, the interval between reviews can be relatively extended. The specific follow-up time and content vary slightly according to the type of disease.
1.Timing.
Within 3 years after surgery: 1 time every 3 months; 4-5 years: 1 time every 6 months.
2.Review content and purpose.
(1) Doctor’s history and physical examination: new onset of abdominal pain, change in bowel habits, rapid weight loss and other symptoms should be alert.
(2) Blood tests: routine blood, liver and kidney function, and gastrointestinal tumor markers.
(3) Imaging tests: ultrasound of abdomen and pelvis, chest X-ray, further review of CT or PET-CT if there is any abnormality, to clarify whether there is metastasis to other organs or lymph nodes.
(4) Colonoscopy: to clarify the healing of anastomosis, local recurrence and recurrence of tumor in other parts of the colon.
(5) Patients who cannot undergo total colonoscopy due to tumor obstruction before surgery: repeat colonoscopy 3 months after surgery.
(6) Patients with ileal prophylactic fistula: review colonoscopy 3 months after surgery or after completion of chemotherapy.
(7) Other patients: colonoscopy 1 year after surgery.