Enterostomy Is Not Necessary For Colon Cancer Surgery | Dr. Ip Shing Fai, David

Colorectal cancer is now the second most common cancer in Hong Kong, with an annual incidence of more than 5,500 cases Its incidence rate is around 200 cases less than the first one, lung cancer. An unhealthy diet that includes lots of meat, fast food, fried food, and lack of dietary fibre, is the leading cause for the increasing intestinal cancer incidence rate in the past decade.

Colorectal cancer is developed from colon polyps. The risk of having colorectal cancer is greatly reduced once the polyps are removed timely. Even if you are diagnosed with colorectal cancer, there is no need to worry too much as the advanced medical technology is able to cure it. 70%-80% of colorectal cancer patients are still alive 5 years after the cancer surgery, if the cancer cell has not spread into other organs.

大腸癌療程​的第一步為外科手術，現時大腸癌的外科手術可分為開腹手術及微創手術兩類：開腹手術是以傳統的開放式手術來切除癌腫瘤及病變組織；微創手術就是於腹部開幾個小洞，利用腹腔鏡切除病變組織，此方法創傷及傷口較小，而且復原快。無論是哪一種方式，均不會只切除癌症腫瘤，而是根據血管及淋巴分佈來切除相關腸段。醫生會根據腫瘤擴散到附近淋巴的情況，再斷定大腸癌的確實期數，考慮兼以化學調理​（化療）來輔助療程​。一般大腸癌一至二期初患者只需要切除有問題的腸段，而二至四期之患者一般都需要於手術後進一步配合化療療程。

There are both permanent and temporary enterostomy. The temporary one is adopted because the risk of dealing with the wound near the anus is higher after rectal surgery. Therefore, a temporary opening is made and the intestines will be connected to the anus again once the wound is healed; The permanent one is adopted when the colorectal cancer is close to the anus and the intestines are unable to connect to the anus after surgery. The patient needs to wear a stoma bag permanently.

The average length of the colon of an adult is 70 cm - 80 cm. The doctor is able to connect the intestines after removing the infected segment. Back in the time when medical technology was relatively not as good, patients undergoing complex colon surgery were required to receive enterostomy and had to permanently wear a stoma bag to defecate. With today's advanced medical technology, the patients are not required to permanently wear a stoma bag after the surgery, if the cancerous tumour is at least 5 cm away from the anus.

曾有患者於檢查時發現腸道出現腫瘤，證實是直腸癌一期。雖然只是非常初期的腫瘤，但其位置太接近肛門，最終未能駁回大腸，而終身需要使用腸造口。由此可見定期檢查的重要性，其實只要盡早發現有機會演變癌症的瘜肉，及時處理掉，就可以大大減低患大腸癌的風險。因此年滿五十歲沒有病徵之人士，或任何年齡人士發現有大腸癌相關的病徵時（如大便習慣改變、便血等），都應根據醫生的建議，盡早進行檢查。