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Title:

COLONIC CANCER

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Title: Author: Michael C Jiang Last modified by: user Created Date: 10/8/1991 8:19:22 AM Document presentation format: – PowerPoint PPT presentation

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Title: COLONIC CANCER


1
? ? ?
  • COLONIC CANCER

2
? ? ? ?
  • ????????
  • ????4150?
  • ?????
  • ????
  • ??????
  • ??????(FAP)
  • ????????

3
(No Transcript)
4
? ? ?
  • ????(Genetic factors)APC K-ras DCC P53
    Sequence of genetic changes
  • ??(Diet) ??? ????? ???
  • ???(Bile acids)
  • ?????(Predisposing conditions) Ulterative
    colitis Crohns disease

5
(No Transcript)
6
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7
? ? ? ? ?
  • ???? ???? ??
  • ??? ?? ??
  • ??? ??? ???
  • ??? ???? ??

8
(No Transcript)
9
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10
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11
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12
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13
Dukes ? ?
  • A? ?????
  • A1 ???????
  • A2 ?????
  • A3?????
  • B ?????,??????
  • C?????,??????
  • C1?????,?????
  • C2?????,???????
  • D?????,????

14
? ? ? ? ? ?
  • 1.????(Lymphatic spread)
  • ???????????????????????
  • 2.????(Blood borne)
  • ?????
  • 3.????(Direct spread)
  • ????
  • 4.??????(Transcoelomic spread)

15
????
  • 1.????
  • ???????
  • 2.??
  • 3.??
  • 4.???
  • 5.????(????)

???????????? ????? ???????? ?? ?????
??????? ?????
16
? ?
?????B??CT?MR, ?? CEA?CA199
17
(No Transcript)
18
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19
? ?
  • ????????????
  • 1.?????????( Bowel preparation)
  • ?? ???????????????????
  • ?? ?????????????
  • 2.????????
  • ???????right hemicolectomy(???? ????????)
  • ?????? middle colic-transverse colectomy
  • ???????left hemicolectomy
  • ??????
  • 3.???????
  • Laparoscopic surgery

20
(No Transcript)
21
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22
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23
? ?
  • 4.????
  • ???????
  • ??????
  • (1)??????
  • (2)????(????)
  • 5 .????(Adjuvant therapy)
  • ?? 5-FUCF
  • ???? ????
  • ???????

24
????????????? ??????????????
??? ??????????????
25
? ? ?
  • RECTAL CANCER

26
  • ??
  • ????????????????????
  • ???
  • ?????????????????????????

27
(No Transcript)
28
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29
???
  • ???? ????
  • ??? ??
  • ??? ????
  • ??? ????
  • ????
  • ??Borders ??
  • ????, ?????,
  • ?????, ??????
  • ????????????????????

30
? ? ? ?
  • ???????,????(??????)
  • ???????,????(??????)????????
  • ????????????
  • ????

31
(No Transcript)
32
? ? ? ?
  • ?????
  • ??????
  • ????????????
  • ?????????????,???
  • ????

33
? ? ? ? ? ?
  • Dukes??(??)
  • A??????
  • A0 ??????
  • A1??????
  • A2????
  • B?????,??????
  • C???????
  • C1?????????
  • C2???????????
  • D???????????
  • TNM??
  • T????
  • N?????
  • M????
  • ??0????? ???

34
? ? ? ?
  • ????
  • ??OB
  • ????
  • ?????????
  • ??????????
  • CT ?B??MR?
  • ????
  • ?????????????

35
? ?
  • 1 .????
  • a.??????????(miles)
  • 7cm
  • b.???????(???Dixon)
  • 7cm
  • c.????????,??????????(Hartmann)
  • d.?????????(Bacon)
  • e.???????(Park)
  • f.????
  • ???????(lt3cm)????
  • ????????????

36
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37
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38
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39
? ?
  • 2.??????????????
  • ??????????
  • ????????-??-?????????
  • 3.???????????
  • ?????????
  • ????????,69??,FuCF
  • ?????(????)
  • 4.????
  • ?????????????

40
Thanks
2002-12
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