Patient: Total pelvic resection was done on August 19, 08 in the outer third due to recurrence of rectal cancer within six months after surgery. Now the condition is basically good. However, a lump the size of a green bean, the color of which is the same as the intestine, has grown on the wall of the anal stoma, and bright red blood oozes out when I change the stoma bag to clean the skin around it, but it is not painful. What is this? Is there any serious problem? Wu Tao, Department of General Surgery, Peking University First Hospital: Thank you for your trust! I’m glad your recovery went well! First: I wonder if you see some black spots? Sometimes the sutures that close the skin and the intestinal wall are not removed which may cause this phenomenon, it is not a big problem. Second: the tightness of the perineal wound is sometimes related to the formation of scar, except for inflammation, recurrence and other problems, should slowly get better with time. Third: two stent tubes can try to pull out; the original urethral opening with oozing is normal and does not need special treatment. I hope my answer will be helpful! In addition, all these problems can be solved at the local hospital; if you are not sure or if conditions allow, it is recommended to return to the hospital for a review. Patient: Professor Wu: Hello! A clear blister the size of a soybean grows from the eye of the suture that was removed from the anus, and a clear yellow fluid flows out after it ruptures, always without crusting. (This is after the drainage opening is healed.) We are using a biweekly chemotherapy regimen, how many months of chemotherapy do we need? How many months of chemotherapy do I need? If I have to have chemotherapy for 6 months, can the patient’s body handle it? The patient is 172 cm tall and weighs 120 pounds. How many doses of Ehren and how many doses of 5fu are appropriate for each chemotherapy treatment? I wish you good work and happiness for the whole family! Wu Tao, General Surgery Department, Peking University First Hospital: Regarding the exudation from the suture eye, if the amount is large, it is recommended to review the pelvic ultrasound to understand whether there is pelvic fluid. If there is no effusion, no special treatment can be given, and a sitz bath may help the healing process. (If you have had radiotherapy before surgery, you are more likely to have some perineal wound healing and fluid accumulation problems.) About chemotherapy: After completing chemotherapy twice before surgery, we generally recommend about 8 times of chemotherapy after surgery, and the specific number of times needs to be adjusted according to the patient’s physical condition and whether the tumor has recurred or not. So if you can adhere to once every two weeks, it actually only takes about four months. According to the patient’s height and weight, his body surface area is about 1.7 square meters; the chemotherapy regimen is generally 85mg/m² of platinum oxalate, 400mg/m² of 5-FU shock dose, and 600mg/m² of maintenance dose, so the dosage of one course of treatment: 150mg of platinum oxalate (three sticks), 680mg of 5-FU shock dose, 1020mg of maintenance dose (1700mg per day. (a total of 3400mg, about 14 sticks). Note: Chemotherapy must be administered in a regular hospital. In addition, you can ask questions in my patient club section, invitation code is 5153. Patient: Thank you very much, Professor Wu! So patient and detailed in answering our questions. I also want to ask: What should I do if I have pelvic effusion? Our hospital here said that 5-FU is a first generation product and Tegafur (I think it is also called Fangk) is a new product, so for the third chemotherapy I used four 5-FU and five Tegafur on the first day and only five Tegafur on the second day. (Here 5-FU is more than 1 yuan and Tegafur is more than 26 yuan.) May I ask Professor Wu which drug is more effective in chemotherapy? In the hospital here, they use a small transparent plastic pump to inject 5-FU or Tegafur into the body in two days at a uniform rate. You are so busy and always bother you, I am so sorry, thank you so much. Wu Tao, Department of General Surgery, Peking University First Hospital: Since all the organs in the pelvic cavity have been removed, a relatively large cavity will remain, and it is easy to produce fluid, which can be absorbed by itself if the amount is not large and does not need special treatment; only when the amount is large or combined with infection does it need to be treated and can be drained by puncture. I think the patient is not yet at this level. Regarding chemotherapy drugs, I suggest that if the local doctor does not particularly insist, 5-FU can be applied, and you can discuss with them. If they insist, it should be fine for both to be the same drug. The way to use it is that it should be titrated continuously for 48 hours, which can maintain a stable blood level very well.