The man read a popular science article and went for a physical examination to find polyps. The doctor recommended surgery to detect early-stage cancer.

Reading Tips: Cancer generally has no symptoms in its early stages.

Whether to add additional surgery is really a question

Here’s what happened. One month ago, a middle-aged male patient, 40 years old, came to me. He came to me with his hospitalization certificate. Said: "Dr. Cui, Director Liang asked me to come to the hospital to have the polyps removed."

I was on duty at the time, so I took his hospitalization certificate and saw that the diagnosis was colon. I had multiple polyps, so I asked him: "Are you feeling uncomfortable? Why do you need a colonoscopy?"

The patient smiled and said to me: "There is nothing uncomfortable. You can eat and drink." , aren’t physical examinations popular nowadays? After reading Director Liang’s popular science, several of our friends made an appointment to see Director Liang for a physical examination and had a gastrointestinal endoscopy. It turned out that one of my friends and I had polyps in our intestines. Director Liang said that My friend’s polyps can be treated electively within a year. He said that my polyps were not in good shape and were too large, so they needed to be hospitalized and removed as soon as possible. He said that polyps like mine might become cancerous and it was not advisable to wait. I cleaned up and came right away. Let’s arrange it as soon as possible. I have to go home and go to work after the cutting!”

I continued: “Don’t worry, we have a process and need to check it!” Platelets, coagulation status, and cardiopulmonary function, etc., make preoperative preparations to ensure the safety of the operation. We will make arrangements for you as soon as possible.”

After making all preoperative preparations, the next afternoon, Our director Kuang Shengli performed resection of colon polyps on him, and a larger polyp was sent for pathological examination. The patient recovered well after the operation and has resumed eating. There has been no bleeding or perforation. He is waiting for the pathology results to come out so that he can arrange for a review. The patient is also ready to be discharged.

At this time, the patient's pathology results came out, which reported villous tubular adenoma with high-grade intraepithelial neoplasia and canceration, and the canceration was classified as moderately differentiated adenocarcinoma. Looking at such pathological results, the patient and his family members felt as if a basin of cold water had been poured down on their heads, from the tips of their hair to their heels. Their enthusiasm for going home suddenly dropped to freezing point. What should we do? Patients and their families are anxious and at a loss what to do!

At this moment, Director Liang was doing his rounds, so he called the patient, his family, and the doctors from our team together, and said to the patient: "Based on experience, I still want to congratulate you for having cancer!” This is also one of the things that Director Liang often explains to patients during ward rounds. Director Liang said: “The intestinal wall of the colon has four layers, namely the mucosal layer, submucosa, muscularis propria and serous layer. The film layer corresponds to the wall paint, mud, bricks and exterior paint layers in the corridor. At present, it is certain that the lesions are only in the paint or mud and have not invaded the brick layer, so it must be early-stage cancer. However, we cannot confirm whether it is just In the coating layer, there is a fear that if the mucosa layer enters the mud layer, the mucosal layer cannot be completely removed by simply peeling off the colonoscopy. There are two options to choose from. First, after the treatment is completed, regular reexamination; second, if it is true, Don't worry, our philosophy is a bit "left", because the surgery in this area is relatively easy and the trauma is not serious, so we go to the surgery for additional laparoscopic surgery. That way, the patient will be more at ease! Later, the patient chose to be transferred to surgery for laparoscopic colon cancer radical treatment! After the operation, the postoperative pathology was even more surprising and exciting. Chronic inflammation of the colon mucosa, interstitial edema, lymphoid tissue proliferation, irregular expansion of blood vessels, congestion, and bleeding; no tumor tissue was found on the upper resection margin of the lymph nodes sampled (0/8). No tumor tissue was found; no tumor tissue was found at the lower resection margin. This also shows that the patient has obtained the result of complete resection simply through our colonoscopy surgery, and their hanging heart has finally returned.

As you write this, you may be able to see that this patient benefited greatly from the physical examination. The physical examination allowed him to discover cancerous colon polyps, saving himself and his family. If he had waited until he had symptoms to do it Gastroenteroscopy, I'm afraid this is not the result.

Maybe you will ask, this patient and his family, when they knew that the surgery did not find cancer, maybe they could not have this additional surgery, do they regret it? I tell everyone, they really regret it! But, this is medicine, everything is uncertain! Director Liang told us that the reason for asking the patient for additional surgery was that the patient was young and the tumor was in a relatively good location, so the surgery would not have a big impact on his life; and the patient did not have to worry about recurrence all day long. Transfer and a series of troubles. If it is an elderly patient, we may advise the patient to observe conservatively after endoscopic treatment and not perform additional surgery. In many cases, whether additional surgery is needed after endoscopic treatment, in addition to technical issues, humanistic factors must also be considered. Additional surgery is a real problem!

During ward rounds, Director Liang always taught us not to be afraid of wasting words, but to educate patients more. my country’s cancer big data shows that the number one cancer among men is lung cancer, and the second is gastrointestinal tract. For tumors, for daily physical examination, you only need to take a chest CT scan or a gastrointestinal endoscopy to detect early tumors in time, which can benefit more people. Now that the country advocates universal health, doctors must do a good job in popularizing these sciences; This is what I admire so much about Director Liang! ! !