Cancer of a sigmovidny gut
Cancer of a sigmovidny gut – the malignant new growth of an epitelialny origin which is settling down in sigmovidny department of a large intestine. At initial stages flows asymptomatically. Then there are pains and discomfort in a stomach, a meteorizm, feeling of incomplete depletion of intestines. Alternation of locks and ponos is observed. Quite often in the left half of a stomach it is possible to probe opukholevidny education. The diagnosis is exposed on the basis of complaints, the anamnesis, data of external survey, ultrasonography, a rektosigmoskopiya, irrigoskopiya, MRT, biopsy and other researches. Treatment – operation, chemotherapy, radiotheraphy.
Cancer of a sigmovidny gut
Cancer of a sigmovidny gut – rather widespread malignant tumor which affects the site of a large intestine located above a rectum. Comes from cages of a ferruterous epithelium. Makes 34% of total of cases of a colorectal cancer. In 60% of cases strikes patients at the age of 40-60 years. Men suffer 1,5 times more often than women. In the beginning cancer of a sigmovidny gut quite often proceeds asymptomatically or malosimptomno that complicates timely diagnostics. When progressing the tumor extends to nearby bodies, gives regionarny and hematogenic metastasises (in a liver, lungs, a backbone, is more rare – in other bodies). Treatment is carried out by experts in the sphere of oncology, a proktologiya and abdominal onkokhirurgiya.
Reasons of cancer of a sigmovidny gut
The high probability of development of cancer of a sigmovidny gut is caused by features of this body. The Sigmovidny gut settles down in the left part of a stomach, over a rectum at once, and has the S-shaped form. At delay of advance of contents on intestines long time remains in a sigmovidny gut that increases time of contact of toxic products of processing of food with mucous body. As the factors increasing risk of development of cancer of a sigmovidny gut consider an inactive way of life and irrational food: the use of products with small amount of vegetable cellulose, a large number of greasy, fried and spicy food, prevalence of animal fats and light carbohydrates. Both of these factors cause delay of an intestinal vermicular movement. Irrational food promotes increase in amount of cancerogenic substances in intestinal contents.
Among other circumstances increasing probability of developing of cancer of a sigmovidny gut, experts call locks at which the mucous membrane not only long contacts to carcinogens, but also is injured by firm contents. A negative role is played by abuse of alcohol. Besides, cancer of a sigmovidny gut often develops against the background of precancer processes and inflammatory diseases of intestines. More than 50% of new growths arise against the background of polyps of the intestines, a divertikulit and other states which are followed by injury of a mucous membrane. Adverse heredity matters.
Classification of cancer of a sigmovidny gut
Taking into account features of growth allocate two types of new growths of a sigmovidny gut: ekzofitny and endofitny. Ekzofitny tumors grow mainly in a gleam of intestines and speakers represent knots on a thick leg. When progressing process cancer of a sigmovidny gut izjyazvlyatsya often, bleedings and infection are possible. Endofitny tumors grow mainly deep into intestines. They extend on an intestinal wall and can cover a gut tsirkulyarno. In the center of a new growth there are sites of an ulceration. Circular growth of cancer of a sigmovidny gut causes narrowing of a gleam of intestines and complicates the movement of kalovy masses. Endofitny tumors are more characteristic of a sigmovidny gut.
Taking into account a histologic structure distinguish three types of cancer of a sigmovidny gut:
- Adenocarcinoma. Comes from cages of a ferruterous epithelium. Comes to light in 75-80% of cases of this disease. Can be high-differentiated, moderately differentiated and low-differentiated. The level of a differentiation of cancer of a sigmovidny gut is lower – the forecast is worse.
- Mucous (mukozny) adenocarcinoma. Is a kind of the low-differentiated adenocarcinoma. It is presented by the mutsinozny cages allocating a large amount of slime. Rapid growth and early metastasis is characteristic.
- Cricoid and cellular cancer of a sigmovidny gut. It is presented by the atypical cages of a cricoid form which are formed owing to an intracellular congestion of a mutsin who removes kernels of cages to the periphery. It is diagnosed for 3-4% of patients with oncological defeats of a sigmovidny gut. Proceeds adversely.
Taking into account prevalence of process distinguish the following stages of cancer of a sigmovidny gut:
- 1 stage – the size of a tumor does not exceed 2 cm, the knot is in limits of a mucous or submucous layer. Regionarny and hematogenic metastasises are not found.
- 2A a stage – the size of a tumor makes less than a half of length of a circle of a gut. Cancer of a sigmovidny gut does not sprout an intestines wall. Regionarny and hematogenic metastasises do not come to light.
- 2B a stage – the tumor affects an intestines wall, but does not go beyond its limits. Metastasises in lymph nodes come to light. The remote metastasis is absent.
- 3A a stage – diameter of a tumor exceeds a half of length of a circle of a gut. Metastasises are not found.
- 3B a stage – limfogenny metastasises come to light.
- 4A a stage – cancer of a sigmovidny gut blocks an intestines gleam. Hematogenic metastasises come to light.
- 4B a stage – the new growth strikes nearby bodies with formation of conglomerates, entero fistulas etc.
Symptoms of cancer of a sigmovidny gut
At early stages a current asymptomatic or with poor clinical manifestations. Patients can show complaints to swelling and abdominal murmur, alternation of locks and ponos. When progressing cancer of a sigmovidny gut prevalence of locks is observed. In Calais impurity of slime, pus and blood appear. At germination of a wall of intestines and existence of a mechanical obstacle to advance of a himus there are skhvatkoobrazny or dull aches in the left half of a stomach. Sometimes development of intestinal impassability becomes the first display of a disease.
At patients with cancer of a sigmovidny gut weakness, fatigue, pallor or a grayish shade of skin, a hyperthermia, the loss of weight and appetite caused by cancer intoxication come to light. At development of intestinal impassability there are pristupoobrazny skhvatkoobrazny pains repeating every 10-15 minutes, the abdominal distension, a delay of a chair and gases is noted. Vomiting is possible. At destruction of a wall of a gut peritonitis develops. In the started cases of cancer of a sigmovidny gut the kakheksiya, anemia, jaundice and increase in a liver are observed. At emergence of hematogenic metastasises the symptoms demonstrating violation of functions of the struck bodies join.
Diagnosis of cancer of a sigmovidny gut
The diagnosis is exposed taking into account the anamnesis, complaints, the yielded objective survey and results of additional researches. The most informative at cancer of a sigmovidny gut are endoscopic methods (a rektoromanoskopiya and kolonoskopiya) allowing to estimate visually the volume and localization of a tumor, and also to take material for the subsequent histologic research. In the course of inspection of patients with suspicion of cancer of a sigmovidny gut also use an irrigoskopiya and the analysis a calla on the hidden blood.
Apply to identification of metastasises ultrasonography of abdominal organs, a thorax X-ray analysis, a X-ray analysis of a backbone and other diagnostic techniques. The final diagnosis is exposed on the basis of results of a histologic research. Cancer of a sigmovidny gut is differentiated with inflammatory and precancer diseases of intestines, with mobile tumors of a bryzheyka and motionless new growths of zabryushinny space.
Treatment and the forecast at cancer of a sigmovidny gut
At treatment of this pathology usually use the combined therapy including surgical intervention, radiotheraphy and chemotherapy. At the same time the leading role is assigned to the expeditious treatment directed to radical removal of a tumor. The volume of operation depends on prevalence of cancer of a sigmovidny gut. At early stages application of endoscopic techniques is in some cases admissible.
At widespread processes carry out a resection of a sigmovidny gut with the site of a bryzheyka and nearby lymph nodes. The affected area is deleted with 5 centimeters of the intestines which are not changed disteel and proximal departments. Surgical intervention at cancer of a sigmovidny gut happens one - or two-stage. When carrying out one-stage operations after removal of a tumor the surgeon imposes , restoring an intestines continuity. In the started cases the gut is rezetsirut with formation of a kolostoma, and integrity of intestines is restored in several months from the moment of the first operation.
In before - and the postoperative period the patient with cancer of a sigmovidny gut appoint chemotherapy and radiotheraphy. In the started cases carry out palliative therapy for ensuring passability of intestines and reduction of a pain syndrome. Sometimes at cancer of a sigmovidny gut the emergency surgeries directed to elimination of intestinal impassability, sanitation of an abdominal cavity at peritonitis etc. are required.
The forecast at cancer of a sigmovidny gut is defined by tumor type, prevalence of malignant process, level of a differentiation of cages, age of the patient, existence of associated diseases and other factors. Average five-year survival makes 65,2%. At new growths of 1 stage the five-year boundary is overcome by 93,2% of patients. At cancer of a sigmovidny gut 2 stages up to five years from the moment of diagnosis live 82,5% of patients. At tumors 3 stages this indicator decreases to 59,5%, at defeats 4 stages – to 8,1%.