Những người có bệnh tiểu đường, đậu rót celiac, rối loạn tuyến tụy, hoặc rối loạn đường ruột nhỏ, du khách tới các nước thế giới thứ ba, bệnh nhân nhiễm HIV, người dân về thuốc kháng sinh, bệnh nhân hoặc điều trị phóng xạ đã, bệnh nhân đã phẫu thuật dạ dày, ruột non, hoặc dấu hai chấm, cá nhân tiếp nhận | Chapter 5 Tumor Mesorectum Figure 1. The area removed during mesorectal resection. freely mobile by digital rectal examination. Tumors should be 9 cm from the anal verge and no lymph nodes should be detected on endoscopic ultrasound. The procedure is performed using a proctoscope or with anal dilatation and retractor insertion. Removal of a margin of about 1 cm of normal mucosa around the tumor with a full thickness resection of the rectal wall is performed. Additional comments The use of endoscopic mucosal resection has been advocated by some as an alternative to transanal resection for small rectal tumors. Since this technique involves resection of the mucosa only I would only advocate this procedure for TOO F di 1 1 TĨ 1 Fl Fc V a 7 h CT 1 TO 4 V FjT 4 TT1 7 Hi rfwi _T 1 c Lr Fvo n Cd TÌ ci I TO O o Fl T 1 Fl Fc lecLaicaiiceiB 1 iflaLienLswiicjaieex enieiy iiigBL-nsKLiaiisaiiaiiesecLioiiDaLieiiLs. This is trial version 130 Chapter Medical therapy for rectal cancer Local recurrence after resection for rectal cancer is common average 30 local recurrence rate . Patients with TNM stage II Dukes B2 rectal cancer have a 25 -30 likelihood of local recurrence and those with TNM stage III Dukes C have a 50 probability of local recurrence. Local recurrence in patients with TNM stage I appears to be less than 10 . Pre or postoperative radiation therapy significantly reduces the rate of local recurrence but does not appear to significantly affect long-term survival. Recent studies have demonstrated that postoperative combination radiation therapy and chemotherapy significantly improve patient survival and reduce both local and systemic postoperative recurrences in patients with TNM stage II Dukes B2 and TNM stage III Dukes C rectal cancer. Current therapy for TNM stage II and III rectal cancer Pre or postoperative radiation therapy combined with 5-fluorouracil 5-FU and leucovorin or 5-FU and levamisole. Adjuvant chemotherapy is usually well tolerated. .
