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The smaller the colorectal cancer surgery wound, the better? Laparoscopists: the most important thing for the patient

 In recent years, cancer medicines have paid attention to "precise" treatment, and the most suitable medicines have been selected according to the individual's constitution! Physicians point out that the same goes for surgical options! "A lot of people hear their doctors recommend open surgery and think they're 'must be in bad shape'. In fact, "Whether it can be minimally invasive, does not mean that the patient's condition is worse or better! The main thing is that the patient must trust that your doctor will help you choose a better method."

Although he has been deeply involved in laparoscopic surgery for many years, Dr. Chen Zhoubin, director of the surgical department of Taichung Veterans General Hospital, does not believe that the smaller the wound, the better. "The key is to select the appropriate patient."

In 1995, when few people in the colorectal surgery department performed laparoscopic surgery, Dr. Chen Zhoubin, at the suggestion of the American instructor, started with animal experiments, and learned to do laparoscopic surgery by watching videos of other people's operations. He further studied in Strasbourg, France, where he saw and learned the amazing laparoscopic surgery method.

Later, his younger brother, Dr. Chen Zhoucheng, also chose colorectal surgery. The two brothers were in the same field and pursued the treatment strategy to keep the patient's "intestine" safe for a long time.

Chen Zhoubin's technology is not hidden! He said, "I don't only teach my younger brother, and I don't want to be the only one who can drive." Therefore, a set of SOPs was established in Taichung Rong Zong. The purpose "is to hope that everyone can do it!"

"No matter how one person can open one, one per day means three hundred and sixty-five knives a year! But Taiwan now has more than 16,000 new colorectal cancer patients in a year! It is impossible to rely on one person. force." Chen Zhoubin said.

He said that when he just started doing minimally invasive laparoscopic surgery, not only the patient had never heard of it, but also the nursing staff had never cared for it, so he had to communicate with the patient, and he had to carry a small TV with a "VHS" video tape. Play the unedited picture to let everyone know what minimally invasive is.

I just hope that patients, their families and nurses can understand why minimally invasive surgery is needed, and that patients are willing to accept minimally invasive surgery! "The first patient's impression was of a patient in his 40s. He went to see him the next day after the operation and was able to get out of bed and walk." "So we already knew at the time that the advantages of minimally invasive surgery are small wounds and quick recovery. .It also strengthened my determination to keep doing it.”

"Now it's the other way around. Almost everyone says they want minimally invasive surgery." At this time, another problem point also emerged! It's when the doctor says, "I saw your film and I assess that you should use traditional surgery to have a meeting, and often the patient or the patient's family thinks that they are more serious?"

Chen Zhoubin emphasized, "Minimally invasive surgery is only one of the tools used by doctors! If your doctor happens to be able to do it and does it well, then the patient can choose it as an option!" After all, because the wound is small, the trauma is small, and the immune system Recovery will be quicker and less painful, so the hospital stay may be shorter and the prognosis may be better.

But it is worth noting that facing cancer is not the same as facing benign tumors. You can’t just pursue small wounds. “Although we open a small hole in the stomach, after entering, it must be able to achieve the same scope as traditional surgery. ." Chen Zhoubin felt that this was the real point.

As for what colorectal cancer patients are suitable for minimally invasive surgery? Chen Zhoubin pointed out that the first is that the patient or the patient's family must have the will, I believe that the minimally invasive can be as good as the traditional! Second, it depends on the doctor's judgment, including from the image, and whether the patient has undergone abdominal surgery, or the overall physical condition, such as easy bleeding, or the tumor is too large? After all, if the tumor exceeds ten centimeters, it will require a ten centimeter wound just to remove the tumor. As a result, the significance of minimally invasive surgery is not so great.

Are there any situations where laparoscopic surgery is definitely not recommended? He pointed out that, for example, if the tumor has invaded another organ, although it is okay to use minimally invasive procedures, "personally, it is recommended to simply use the traditional method, which is faster."

"Can you be minimally invasive, it doesn't mean that your condition is worse or better! The main thing is that you have to believe that your doctor will help you choose a better method."

Dr. Chen Zhoucheng said, simply put, "The first thing is to take into account the safety of the patient, and then help the patient consider whether there are relevant insurance or economic factors. In the end, it is within the acceptable range of the patient to give them more options!"

In fact, the discovery period is the most important factor! Dr. Chen Zhoucheng pointed out that the Taichung General Manager recently counted the patients receiving minimally invasive laparoscopic treatment, and mainly conducted a survey on 1,589 colorectal cancer patients, and found that the ten-year survival rate was about 84%. Among them, the first and second stages went from 99.3% and 95.3% to over 84% in the third stage, but once it entered the fourth stage, because the cancer cells have been transferred out, the survival rate The decline is relatively fast, but the five-year survival rate is still about 24%. "On the whole, we still encourage everyone to early detection and early treatment."

Dr. Chen Zhoucheng pointed out that since 2013, the government has promoted four-cancer screening, including non-invasive fecal occult blood test, in the hope of helping people to detect colorectal cancer early.

"However, it is worth noting that only 70% of people who are positive for fecal occult blood will undergo further colonoscopy. The other 30% may be afraid of pain or think that they will be fine without the test!" Chen Zhoubin pointed out that one hundred fecal occult blood were positive. Among them, there are actually only about three colorectal cancers, and most of them are early stage one or two stage cancers. More importantly, 30% of adults in this test were found to be only colon polyps. If these polyps are left unchecked, they may develop colorectal cancer in the future, that is, precancerous lesions. This is very valuable, so the fecal occult blood test is positive. Patients must have a colonoscopy to increase their chances of staying away from colorectal cancer.


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