rak pryamoy kishki

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slayd 1 “rak pryamoy kishki” epidemiologiya raka pryamoy kishki chastota raka pryamoy kishki v obshey strukture zlokachestvennix opuxoley sostavlyaet do 10%.statisticheskie dannie o zabolevaemosti rakom pryamoy kishki v razlichnix stranax mira na 100 000 naseleniya neodinakovi: v ssha — 33,2%, shvetsii — 17,8%, velikobritanii — 25,8%, yaponii — 15,7%, senegale — 2,5%. samaya visokaya zabolevaemost rakom pryamoy kishki otmechaetsya v ssha, gde v strukture zabolevaemosti on zanimaet vtoroe mesto posle raka legkogo u mujchin. rak pryamoy kishki vstrechaetsya v lyubom vozraste, odnako na osnovanii rezultatov issledovaniy provodivshixsya na protyajenii mnogix desyatiletiy ustanovleno, chto eto zabolevanie porajaet v osnovnom lits pojilogo vozrasta / starshe 60 let. etiologiya i patogenez na rost zabolevaemosti kolorektalnim rakom okazivayut vliyanie sleduyushie faktori: • xarakter pitaniya (maloshlakovaya pisha s preobladaniem jivotnix jirov, belkov i rafinirovannix uglevodov (saxar). • malopodvijniy obraz jizni. • gipotoniya i atoniya kishechnika v pojilom vozraste — xronicheskie zapori. • nalichie v kishechnom …

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tanie seroznoy obolochki i nalichie regionarnix metastazov; d — nalichie otdalennix metastazov. klassifikatsiya raka pryamoy kishki naibolee shirokoe rasprostranenie i priznanie poluchila mejdunarodnaya klassifikatsiya raka pryamoy kishki, predlojennaya mejdunarodnim protivorakovim soyuzom s ispolzovaniem simvolov tnm (tumor, nodulus, metastases). simvol t soderjit sleduyushie gradatsii: tx — nedostatochno dannix dlya otsenki pervichnoy opuxoli; tis — preinvazivnaya kartsinoma; t1 — opuxol infiltriruet slizistuyu obolochku i podslizistiy sloy pryamoy kishki; t2 — opuxol infiltriruet mishechniy sloy, bez ogranicheniya podvijnosti stenki stenki kishki; t3 — opuxol, prorastayushaya vse sloi stenki kishki s infiltratsiey ili bez infiltratsii pararektalnoy kletchatki, no ne rasprostranyayushayasya na sosednie organi i tkani. dlya opuxoley, raspolojennix v verxneampulyarnom i rektosigmoidnom otdelax pryamoy kishki (pokritix bryushinoy), poslednie rasprostranyayutsya do subserozi (ne prorastayut serozu). t4 — opuxol, prorastayushaya v okrujayushie organi i tkani. simvol n ukazivaet na nalichie ili otsutstvie regionarnix metastazov. nx — nedostatochno dannix dlya otsenki regionarnix limfouzlov n0 — porajeniya regionarnix …

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li yazva do 5 sm v diametre, zanimayushaya menee ½ okrujnosti prosveta kishki, ne vixodit za predeli ee stenki (narujnogo mishechnogo sloya). pri etom: iia stadiya — bez regionarnix metastazov, iib stadiya — s nalichiem regionarnix metastazov. iii stadiya — opuxol ili yazva bolee 5 sm v diametre, zanimayushaya bolee ½ okrujnosti prosveta kishki, prorastayushaya vse sloi ee stenki s infiltratsiey ili bez infiltratsii pararektalnoy kletchatki. iiia stadiya — bez regionarnix metastazov, iiib stadiya — s nalichiem regionarnix metastazov. iv stadiya — obshirnaya, nepodvijnaya opuxol, prorastayushaya okrujayushie organi i tkani ili opuxol lyubix razmerov pri nalichii otdalennix metastazov. iva stadiya — bez otdalennix metastazov, ivb stadiya — opuxol lyubix razmerov pri nalichii otdalennix metastazov. patologicheskaya anatomiya patologicheskaya anatomiya makropreparat pryamoy kishki - adenokartsinoma klinika proyavleniya raka pryamoy kishki rakovie opuxoli pryamoy kishki xarakterizuyutsya medlennim rostom i postepennim poyavleniem klinicheskix simptomov. virajennie proyavleniya bolezni voznikayut togda, kogda opuxol dostigaet bolshix razmerov. …

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ltsevom osmotre kishki mojno viyavit opuxoli na rasstoyanii do 15 sm ot zadnego proxoda i daje vishe. vsyu pryamuyu kishku mojno osmotret pri rektoromanoskopii — osmotr kishki cherez rektoskop — spetsialnuyu poluyu metallicheskuyu trubku, k kotoroy podveden istochnik sveta. krome togo, ispolzuyutsya rentgenovskie metodi (irigografiya). ultrazvukovoe issledovanie s datchikom, vvodimim v pryamuyu kishku, pozvolyaet otsenit stepen prorastaniya opuxoli sloev stenki kishki. traditsionnoe uzi — isklyuchit metastazi v limfaticheskix uzlax i v pecheni. v poslednee vremya dlya diagnostiki opuxoley tolstoy kishki ispolzuyutsya kompyuternaya, magnitno-rezonansnaya, pozitronno-emissionnaya tomografii — produkti novix texnologiy v meditsine, kotorie yavlyayutsya nadejnimi i dostatochno tochnimi kak v diagnostike opuxoli, tak i v otsenke ee rasprostranennosti. takje primenyaetsya biopsiya opuxolevogo obrazovaniya dlya verifikatsii i tochnoy diagnostiki tipa opuxoli rektoromanoskopiya adenokartsinoma diagnostika rentgenovskiy metod norma diagnostika rentgenovskiy metod endofitniy rak diagnostika rentgenovskiy metod ekzofitniy rak patomorfologiya raka pryamoy kishki adenokartsinoma patomorfologiya raka pryamoy kishki adenokartsinoma lechenie raka pryamoy kishki lechenie …

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dalyayut, «verxniy» konets kishki vivodyat v vide kolostoma, a «nijniy» — zashivayut. eta operatsiya vipolnyaetsya, kogda est bolshoy risk sshivat kontsi kishki. posle nee mojno kolostomu likvidirovat pri povtornoy operatsii. pri bryushno-analnoy rezektsii porajennuyu opuxolyu kishku udalyayut, a «verxniy» konets kishki protyagivayut vnutr «nijnego», jdut, poka oni ne srastutsya, a potom otsekayut izbitok protyanutoy v zadniy proxod kishki. xirurgicheskoe lechenie rpk bryushinno-promejnostnaya amputatsiya pryamoy kishki po miles xirurgicheskoe lechenie rpk perednyaya rezektsiya pryamoy kishki po dixon xirurgicheskoe lechenie rpk bryushinno-promejnostnaya amputatsiya pryamoy kishki po milesi. bryushinnaya faza. mobilizatsiya sigmovidnoy kishki s levoy storoni, po linii embrionalnogo prikrepleniya xirurgicheskoe lechenie rpk bryushinno-promejnostnaya amputatsiya pryamoy kishki po miles. bryushinnaya faza. rassechenie brijeyki sigmovidnoy kishki i bryushini dna taza p-obraz-nim razrezom xirurgicheskoe lechenie rpk . bryushinno-promejnostnaya amputatsiya pryamoy kishki po mites. bryushinnaya faza. peresechenie verx-ney arterii pryamoy kishki xirurgicheskoe lechenie rpk bryushinno-promejnostnaya amputatsiya pryamoy kishki po miles bryushinnaya faza. osvobojdenie pryamoy kishki iz …

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slayd 1 “rak pryamoy kishki” epidemiologiya raka pryamoy kishki chastota raka pryamoy kishki v obshey strukture zlokachestvennix opuxoley sostavlyaet do 10%.statisticheskie dannie o zabolevaemosti rakom pryamoy kishki v razlichnix stranax mira na 100 000 naseleniya neodinakovi: v ssha — 33,2%, shvetsii — 17,8%, velikobritanii — 25,8%, yaponii — 15,7%, senegale — 2,5%. samaya visokaya zabolevaemost rakom pryamoy kishki otmechaetsya v ssha, gde v strukture zabolevaemosti on zanimaet vtoroe mesto posle raka legkogo u mujchin. rak pryamoy kishki vstrechaetsya v lyubom vozraste, odnako na osnovanii rezultatov issledovaniy provodivshixsya na protyajenii mnogix desyatiletiy ustanovleno, chto eto zabolevanie porajaet v osnovnom lits pojilogo vozrasta / starshe 60 let. etiologiya i patogenez na ros...

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