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perianal Tumor Treatment Guide-Perianal Tumor

perianal Tumor Treatment Guide-Perianal Tumor
The Perianal Tumor Treatment Guidelines provide answers to questions that often arise when patients with perianal tumors go to the hospital for treatment, such as: What department number is associated with perianal tumors? What are the precautions before the examination of perianal tumors? What do doctors usually ask? What examinations should be done for perianal tumors? How do I look at the results of the perianal tumor? and many more. The perianal tumor consultation guidelines are designed to facilitate the treatment of patients with perianal tumors and solve the doubts of patients with perianal tumors.
Typical symptoms
Anal itching, blood in the stool, liver metastases
Recommended department
Oncology, Anorectal Surgery
Best time to visit
Nothing special, see a doctor as soon as possible
Length of visit
1 day is reserved for the first visit, half a day is reserved for each follow-up visit
Follow-up frequency/diagnostic cycle
Outpatient treatment: follow up every week until the symptoms of anal pain and bleeding are relieved, and then follow up for follow-up.
Preparation before seeing a doctor
No special requirements, pay attention to rest.
Frequently Asked Questions
1. Describe the reason for the visit (when did you feel uncomfortable?)
2. How much weight is lost, how much food you eat every day, how much you increase than usual, and the relationship between weight and diet.
3. Is the discomfort caused by obvious factors?
4. Are there accompanying symptoms such as swollen inguinal lymph nodes, pus and blood in the stool?
5. Stool and sleep conditions.
6. Have you ever been to the hospital for medical treatment, have you done those tests, and what are the results of the tests?
7. How is the treatment?
8. Is there a history of drug allergy?
9. Are there any patients with perianal tumors in the 4 families?
Key inspection items
1. CEA testing
The clinical significance is very limited, the positive rate is not high, and the increased level is not directly related to tumor development and staging. It may be helpful for diagnosing liver metastasis and monitoring tumor recurrence. The expression of squamous cell carcinoma antigen is highly sensitive in anal canal cancer. Sex and specificity, but have nothing to do with tumor staging, clinical application is limited, HPV antigen detection, etc. have been reported, and its clinical value needs to be further studied.
2. Digital anal examination
Biopsy is required for any suspicious lesions around the anal canal and anus. If suspicious lymph nodes in the groin are found, a biopsy should be performed. Histological examination can also distinguish anal squamous cell carcinoma from adenocarcinoma. For some patients who feel obvious pain, it needs to be performed under anesthesia. Fine needle aspiration biopsy is also feasible for enlarged inguinal lymph nodes; for highly suspected lesions, if the needle result is negative, surgical biopsy should be performed.
3. Modern imaging methods
Liver B-ultrasound, CT and lung X-ray examinations can easily find the presence or absence of liver and lung metastases, and they are also more accurate.
Diagnostic criteria
The diagnosis of this disease depends on the anal canal, digital rectal examination and biopsy. Because of the superficial location of the anal canal cancer, the symptoms of bleeding, pain and lumps often appear in the early stage, so the early digital rectal examination is easier to find the lesion, and the digital anal examination can Understand whether there is a perianal disease, and at the same time make basic judgments on the location and size of the disease. Any suspicious perianal disease should be biopsy. The vaginal palpation of the surrounding tissue is very helpful to understand whether the disease has infiltration. Especially for judging whether there is violation of the rectum and vagina. During the anorectal examination, a circular stenosis can be found, and the patient may have obvious pain. Therefore, it can be performed under general anesthesia if necessary. A digital examination can also determine whether there is metastasis of lymph nodes around the rectum. The enlarged lymph nodes in the groin are easily palpable. However, its clinical significance in the early stage is difficult to judge. In perianal cancer, about one-third of patients may have inguinal lymphadenopathy, and 50% of them can find pathological manifestations that are conducive to the diagnosis of tumors. Most patients have previously suffered from external hemorrhoids, anal fistulas, and perianal abscesses. When the above symptoms appear, they are often mistaken for the above-mentioned benign diseases, and fail to seek treatment in time and delay the diagnosis. In addition, the iatrogenic misdiagnosis rate is also as high as 20%, the main reason is that when the symptoms of anal canal cancer occur, the digital rectal examination is not performed or because the doctor lacks knowledge of anal canal cancer, the malignant tumor is misdiagnosed as a benign disease, and histopathological examination is not performed. Therefore, even if it is Clinically considered benign lesions should also undergo routine biopsy to confirm the diagnosis. About half of the patients have been delayed for 1 month from the onset of the primary symptoms to the diagnosis, and about 1/4 of the patients are delayed for 6 months. Therefore, nearly 50% The patient has become an advanced tumor (T3-T4 stage) when he is diagnosed with anal canal cancer.


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