Papillary adenoma

　　The occurrence of papillary adenomaThere is no clear etiology at present, and it may be related to various factors such as environment, diet, genetics, and lifestyle. Papillary adenoma needs to be detected and treated early. The pathogenesis is unknown..

　　Larger papillary adenomas can discharge a large amount of mucus, which can be discharged with feces or as a large amount of diarrhea containing mucus alone. The daily discharge volume can reach more than 3000mL, often leading to severe dehydration, electrolyte imbalance, circulatory failure, acidosis, and other symptoms that threaten life. This is due to the abnormal function of tumor cells, resulting in the discharge of a large amount of fluid and mucus. Circulatory failure is a systemic pathological process in which the metabolic disorder occurs due to a sharp decrease in tissue perfusion caused by reduced blood volume or acute cardiac dysfunction.

　　Papillary adenoma, also known as villous adenoma in clinical practice, is different from polypoid adenoma. Its characteristic is that the adenoma is not very prominent when it rises from the intestinal wall. The surface is rough and villous. Due to the higher chance of canceration, it is considered a precancerous lesion. It is more common in elderly people over 60 years old, and about 90% of papillary adenomas occur in the rectum and sigmoid colon. In many reports, about 75% of papillary adenomas can transform into cancer. Then, what are the symptoms of papillary adenoma?

　　Typical symptoms of papillary adenoma: diarrhea, dehydration, and circulatory failure.

　　The main clinical manifestations are the discharge of mucus and the feeling of incomplete defecation, which are often misdiagnosed as mucous colitis and bacillary dysentery. Larger papillary adenomas can discharge a large amount of mucus, which can be discharged with feces or as a large amount of diarrhea containing mucus alone. The daily discharge volume can reach more than 3000mL, often leading to severe dehydration, electrolyte imbalance, circulatory failure, acidosis, and other symptoms that threaten life. This is due to the abnormal function of tumor cells, resulting in the discharge of a large amount of fluid and mucus.

　　Papillary adenomas are different from polypoid adenomas. Their characteristic is that the adenomas rise from the intestinal wall but are not very prominent. The surface is rough and bristly, and due to the higher chance of cancer development, it is considered a precancerous lesion. So, what are the prevention methods for papillary adenomas? There are no special preventive measures for papillary adenomas, and the key is early detection and early treatment.

　　Papillary adenomas also need to pay attention to potentially carcinogenic foods in diet:

　　1, Salted fish.

　　Salted fish produces dimethyl nitrosamine, which can be converted into carcinogenic dimethyl nitrosamine in the body. If a person often eats salted fish from birth to 10 years old, the possibility of developing nasopharyngeal cancer in the future is 30-40 times higher than that of people who do not eat salted fish. Fish sauce, shrimp paste, salted eggs, salted vegetables, sausages, ham, smoked pork, etc., also contain a lot of nitrosamine carcinogens and should be eaten as little as possible.

　　2, Barbecued food.

　　Grilled beef, grilled duck, grilled lamb, grilled geese, braised pork, etc., contain strong carcinogen 3,4-benzopyrene and are not suitable for eating in large quantities.

　　3, Processed food.

　　Products such as smoked meat, smoked liver, smoked fish, smoked eggs, and smoked tofu also contain benzo(a)pyrene carcinogens, and eating them frequently can easily lead to esophageal cancer and gastric cancer.

　　4, Fried food.

　　After frying food to a crisp, it produces a lot of polycyclic aromatic hydrocarbons, which are carcinogenic. After coffee beans are burned, the content of benzo(a)pyrene increases by 20 times. Most fried dough, stinky tofu, fried taro cakes, fried dough sticks, etc., are made with oil used repeatedly, which will produce a carcinogenic decomposition product under high temperature.

　　5, Moldy food.

　　Rice, wheat, beans, corn, peanuts, and other foods are prone to be moldy and musty, and after being contaminated by mold, various carcinogenic toxins are produced.

　　6, Leftover cooked cabbage.

　　It can produce nitrites, which can be converted into nitrosamine carcinogens in the body.

　　7, Betel nuts.

　　Chewing betel nuts is a factor that can cause oral cancer.

　　8, Repeatedly boiled water.

　　Repeatedly boiled water contains nitrites, which eventually form nitrosamines that are carcinogenic.

　　The above is the dietary prevention for papillary adenomas, hoping it can provide help to everyone. Only by actively preventing diseases can they stay away from us, and early detection and early treatment are the key.

　　Papillary adenomas, also known as villous adenomas in clinical practice, are different from polypoid adenomas. Their characteristic is that the adenomas rise from the intestinal wall but are not very prominent. The surface is rough and bristly, and due to the higher chance of cancer development, it is considered a precancerous lesion. It is more common in elderly people over 60 years old, and about 90% of papillary adenomas occur in the rectum and sigmoid colon. In many reports, about 75% of papillary adenomas can develop into cancer. So, what are the examination items for papillary adenomas?

　　The examinations required for papillary adenomas include rectal examination, colonoscopy, and pathological biopsy.

　　Most papillary adenomas in clinical diagnosis are found through rectal examination, sigmoidoscopy, or colonoscopy, as the adenomas are very soft and can easily be overlooked during rectal examination without careful inspection.

　　When discovering papillary adenoma, a thorough palpation of the entire adenoma should be performed. Adenomas with uniform texture and very softness are more likely to be benign structures. Palpation of papillary adenoma with small nodules and hardness requires high vigilance for the possibility of malignant transformation. Palpation examination for early diagnosis of malignant transformation in papillary adenoma has certain feasibility. Papillary adenomas that are not palpated clearly can be examined by rectoscope, sigmoid colonoscope, and colon fiberoptic scope. To determine the possibility of tumor malignancy, tissue samples should be taken from different parts of the adenoma surface and base for biopsy.

　　(1) Papillary adenoma, also known as villous adenoma in clinical practice, is different from polypoid adenoma, characterized by the adenoma rising from the intestinal wall without being very prominent. The surface is rough and villous, and due to the higher chance of cancerous transformation, it is considered a precancerous lesion. So, how should the dietary care of papillary adenoma be carried out? The following introduces the dietary taboos for papillary adenoma.

　　I. Foods that papillary adenoma patients should eat

　　(1) Eat more foods that are beneficial for adenoma recovery, such as asparagus, pumpkin, hickory, luffa, tangerine cake, green bamboo leaves, eel skin, crab, red, grasshopper shrimp, needlefish, sea horse.

　　(2) Papillary adenoma patients should eat shark meat, snake meat, antelope meat, muntjac meat, horseshoe crab, pangolin, luffa, sea cucumber, hickory, eggplant.

　　(3) Papillary adenoma patients should eat bitter melon, figs, bitter herbs, radish leaves, oranges, and rose flowers.

　　II. Foods that papillary adenoma patients should not eat

　　(1) Patients with papillary adenoma should avoid smoking, alcohol, coffee, and cocoa.

　　(2) Patients with papillary adenoma should avoid spicy and irritant foods such as scallions, garlic, peppers, and cinnamon.

　　(3) Patients with papillary adenoma should avoid rich, fried, moldy, and preserved foods.

　　(4) Patients with papillary adenoma should avoid chicken, goose, pork head meat, and other irritants.

　　Quit smoking, and pay attention to cultivating good personal living habits. Early clinical diagnosis, examination, and treatment of this disease are conducive to a good prognosis for patients with papillary adenoma.

　　(1) Papillary adenoma, also known as villous adenoma in clinical practice, is different from polypoid adenoma, characterized by the adenoma rising from the intestinal wall without being very prominent. The surface is rough and villous, and due to the higher chance of cancerous transformation, it is considered a precancerous lesion. It is more common in elderly people over 60 years old, and about 90% occur in the rectum and sigmoid colon. In many reports, about 75% of papillary adenomas can transform into cancer. So, what are the treatment methods for papillary adenoma? The following introduces the treatment methods for papillary adenoma.

　　(1) Treatment Principles:

　　Thymoma should be surgically removed as soon as it is diagnosed. The reasons are that the tumor continues to grow and enlarge, compressing adjacent tissues and organs to produce obvious clinical symptoms; it is difficult to judge the benign or malignant nature of the tumor solely based on clinical and X-ray findings; and benign tumors can also become malignant. Therefore, whether benign or malignant, thymoma should be removed as soon as possible. Malignant thymoma that can be removed can be taken for pathological biopsy to guide postoperative treatment, and partial resection can be followed by radiotherapy to alleviate symptoms and prolong the patient's survival.

　　(2) Incision selection:

　　Smaller thymomas that project to one side often use an anterior extrapleural chest incision, while larger tumors projecting to both sides can use a median sternotomy incision. In recent years, the median sternotomy incision has been used more frequently, not only for removing thymoma but also for removing the contralateral thymus to prevent the possibility of later developing myasthenia gravis. There are also cases where a transverse sternotomy incision is used to resect the tumor. The median sternotomy incision does not enter the pleural cavity, reducing interference with the patient's respiratory function after surgery and avoiding postoperative respiratory system complications. Some surgeons remove thymoma through the neck incision, the indications for which are elderly patients with contraindications to thoracotomy, small tumor volume and proximity to the neck.

　　(3) Matters to be noted during surgery:

　　Isolated and non-adherent benign thymoma can be completely removed without difficulty, and the operation can be successfully completed. However, in some complex cases, it is necessary to fully estimate the difficulties during the operation. Malignant thymoma requires an initial exploration to clarify the relationship between the tumor and the surrounding adjacent organs before dissection. Thymoma is located at the base of the superior mediastinum, at the junction of the heart and large blood vessels; malignant thymoma can infiltrate and adhere to surrounding tissues; when the tumor grows, the adjacent tissues and organs are displaced, and the normal anatomical relationship changes; fibrous connective tissue adhesions thicken, making it difficult to distinguish from blood vessels. All these can cause accidental injury to blood vessels during surgery and lead to massive bleeding. The surgeon should be vigilant about this.

　　The judgment of the resectability of the tumor is an issue that must be considered during surgery. When the tumor has invaded the innominate vein or superior vena cava, or the blood vessels are surrounded by the tumor, or the tumor and the surrounding tissues are in a frozen state, a cautious attitude should be adopted, the operation should be stopped, and only pathological biopsy should be taken. Postoperative radiotherapy should be given if the tumor is adherent and infiltrative to large blood vessels but can still be separated. It can be gradually dissected from shallow to deep, from easy to difficult, first making it loose, then freeing the tumor body, and finally removing it by clamping the stalk after it.

　　If the tumor projects from one side of the chest to the other side, or if the tumor body protrudes and extends towards the neck, it should be dissected and separated under direct vision. Sometimes some blood vessels cross between them, or there may be blood vessels supplying the tumor body. Blind钝性分离 can cause bleeding. When the tumor invades the pericardium, the pericardium can be cut open in the normal part, and the finger can be inserted into the pericardial cavity to help remove the tumor or to remove the pericardium and tumor together.

　　The above is the treatment method for papillary adenoma. Once diagnosed, active surgical treatment is required, and radiotherapy and chemotherapy can be used to consolidate the therapeutic effect.