Sigmoid colon tumor
A tumor of the sigmoid colon is a neoplasm of a malignant nature that originates from the epithelial cells of the sigmoid colon. For the initial stages of the development of the disease, an asymptomatic course is characteristic, subsequently pains of the corresponding localization, discomfort in the abdomen will join.
A tumor of the sigmoid part of the intestine is quite common. This section is located slightly above the rectum. Among all colorectal tumors, the proportion of sigmoid colon tumors is 34%. Most often, patients are between 40 and 60 years old. Women, unlike men, get sick 1.5 times less often. The tumor is dangerous by metastasis to nearby organs. The lungs, liver and spine are primarily affected.
Content:
- Causes of a tumor of the sigmoid colon
- Symptoms of a tumor of the sigmoid colon
- Classification of tumors of the sigmoid colon
- Diagnostics of the tumor of the sigmoid colon
- Treatment of a tumor of the sigmoid colon
Causes of a tumor of the sigmoid colon
The causes of a tumor of the sigmoid colon are primarily due to the very structure of this part of the intestine. It is located in the left side of the abdominal cavity and forms the letter S. If the digested food for some reason passes through the intestines slowly, then it is in the sigmoid region that it lingers the longest. The toxic substances contained in the chyme are in contact with the intestinal walls for a long time, causing inflammatory processes, which are the basis for the further development of a malignant tumor.
The factors-provocateurs that increase the risk of tumor formation are:
- Lack of adequate physical activity, sedentary lifestyle.
- Unhealthy diet, predominance of fatty, fried and spicy foods, animal fats and light carbohydrates in the diet. The less plant fiber in the diet, the higher the risk of developing the disease. Such a menu leads to a slowdown in intestinal motility and to the fact that in its intestinal contents the amount of carcinogenic substances will increase.
- Chronic constipation is another reason for tumor formation. They lead to the fact that harmful substances are not excreted from the body for a long time, and the solid feces themselves injure the intestinal mucosa.
- Alcohol abuse increases the risk of developing tumors.
- Any inflammatory bowel disease is dangerous, as well as precancerous conditions, including: polyps, diverticula, etc.
- A genetic predisposition to the development of the disease is found in people whose close relatives have suffered a similar pathology.
Symptoms of a tumor of the sigmoid colon
Symptoms of a tumor of the sigmoid colon in the early stages of the development of the disease are almost impossible to notice. This is the main danger of the disease. Asymptomatic progression often leads to the fact that the tumor can be detected at the later stages of its development.
Signs that may indicate a tumor process in the sigmoid colon are as follows:
- Feeling of discomfort in the intestines, bloating, rumbling and overflow, symptoms of flatulence. Sometimes they are subtle, and sometimes they can seriously disrupt the patient's quality of life.
- If in the early stages of the development of the disease, the stool is most often unstable (constipation is replaced by diarrhea), then as the tumor grows, it is constipation that begins to prevail in people.
- In the feces, streaks of blood, impurities of pus and mucus can be seen.
- Cramping pains in the left side of the abdomen may indicate that the tumor has grown into the intestinal wall and interferes with the normal movement of feces. Sometimes the disease is detected during the treatment of the patient for the developed intestinal obstruction.
- Patients experience general weakness and malaise. As the disease progresses, fatigue increases, appetite disappears, weight goes away. The skin acquires an unhealthy grayish tint, the body temperature remains at subfebrile levels for a long time.
- Tumor intoxication of the body is slowly but steadily progressing.
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If a person develops intestinal obstruction, then he experiences severe pain in the type of contractions. They occur in seizures that repeat every 10 minutes on average. Gas ceases to move away, there is no stool, the abdomen increases in size. Sometimes vomiting occurs.
- Peritonitis is a dangerous complication of the tumor process, which develops against the background of destruction of the sigmoid colon wall.
- An enlarged liver in size, yellowing of the skin, anemia - all these symptoms develop during advanced stages of the disease.
Other signs of a tumor process will appear depending on which organ is affected by metastases.
Classification of tumors of the sigmoid colon
Depending on the structure of the tumor, the following types are distinguished:
- Adenocarcinoma presented by glandular cells. This is the most common type of tumor, which is detected on average in 80% of cases. There are three degrees of differentiation of adenomatous neoplasms (high-, medium- and low-differentiated tumors), the lower it is, the lower the survival threshold of cancer patients.
- Mucous adenocarcinomas, which are mucinous cells that produce large amounts of mucus. These neoplasms grow rapidly and metastasize early.
- Cricoid cell tumor is characterized by an unfavorable course, but is rarely detected, in no more than 4% of cases.
Diagnostics of the tumor of the sigmoid colon
Diagnosis of a tumor of the sigmoid colon begins with an examination of the patient, taking anamnesis and patient complaints. The maximum information about the tumor can be obtained after colonoscopy and sigmoidoscopy. These methods make it possible to visualize the tumor, estimate its size, and determine the exact location. During the study, the doctor collects the tumor tissue for subsequent histological analysis.
Feces for occult blood are handed over without fail, and an irrigoscopy is also performed. However, the final diagnosis can only be made based on the results of a histological examination of the tumor. Metastases to other organs are detected using ultrasound, radiography, MRI and CT.
Treatment of a tumor of the sigmoid colon
Treatment of a tumor of the sigmoid colon should be comprehensive. It includes surgery, chemotherapy, and radiation therapy. In this case, the leading role is assigned to the operation, during which the maximum possible removal of the neoplasm is carried out. The extent of the intervention depends on how widespread the tumor is. If the neoplasm was detected in the early stages of development, then it is possible to carry out endoscopic manipulations on the intestine.
Sigmoid colon resection is performed when large tumors are found. In parallel, the lymph nodes located regionally, as well as the mesentery are removed. In addition to the affected tissues, 5 cm of unchanged tissues (proximal and distal) are necessarily captured. It is possible to perform two-stage and one-stage operations. If the intervention is carried out in one stage, then the patient is removed the tumor, after which an anastomosis is applied. This manipulation allows you to maintain the integrity of the intestine. When the tumor is widespread, the sigmoid colon is completely excised and a colostomy is formed. In this case, part of the colon is excreted through the anterior abdominal wall. The second stage of the operation is the formation of an interintestinal anastomosis by means of which part of the large intestine is connected to the rectum. This procedure is performed several months after the first operation.
Before and after surgery, patients are recommended a course of chemotherapy and radiation therapy. If the disease has an advanced stage, then the patient is provided with palliative treatment designed to reduce pain and prolong his life. Emergency operations are performed during the formation of intestinal obstruction, with peritonitis and other conditions that pose a direct threat to the patient's life.
As for the prognosis, it depends on the extent of the tumor process at the time of the start of treatment. The average percentage of five-year survival of such patients is 65%, and if the disease is diagnosed at the first stage, then this figure is equal to 93%, and at the second stage to 82%. It is significant that with a fourth stage tumor, the percentage of five-year survival is only 8%.
The author of the article: Bykov Evgeny Pavlovich | Oncologist, surgeon
Education: graduated from residency at the Russian Scientific Oncological Center. N. N. Blokhin "and received a diploma in the specialty" Oncologist"
