bedah colorectal carcinoma

8/15/2019 Bedah Colorectal Carcinoma

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Colorectal CarcinomaCombined Degree

General Surgery

Udayana Medical Faculty-Sanglah

General HospitalOctober 29th 2!"


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!# $risca Oriana S 2# %ndreasta Ginting 'yandi Satrio "# (#G#)uban *ling +# Gede ,usuma inarta .# Daniel O/ta0ianus Dau 1# ,ade/ Faar Mahendra 3# (#4#5udha $rasistha 9# %#%#% O/a ,usuma De6i

!# (#G#4 Dharma $ra/asa !!# Made Dharmendra !2# 4udiman 'itonga ! ,omang Fuiama

Starring:


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one of the most common cancers in the world

US: 4th most common cancer (after lung,

prostate, and breast cancers)

2nd most common cause of cancer death

(after lung cancer)

Epidemiologi


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)ypical sites o7 incidence and symptoms o7 colon cancer


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Age

Adenomas, Polyps

Sedentary lifestyle, iet, !besity

"amily #istory of $%$

&nflammatory 'owel isease (&')

#ereditary Syndromes (familial adenomatous polyposis ("AP))

Risk Factors


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result of interplay between enironmental and

genetic factors

$entral enironmental factors:

diet and lifestyle

*+ of all cancers are attributable to diet

*+-.*+ of $%$ in the US may be preentable through dietary modifications

eelopment of $%$


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consumption of red meat

animal and saturated fat

refined carbohydrates

alcohol

increased ris/

ietary factors implicated in

colorectal carcinogenesis


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dietary fiber

egetables

fruits

antio0idant itamins

calcium

folate (' 1itamin)

decreased ris/

ietary factors implicated in

colorectal carcinogenesis


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Staging of $%$

A ucosa 3+

' &nto or through propria *+

$5&nto propria, 6 78 9 4+

$2hrough propria, 6 789 52+

distant metastatic spread ;*+

u/es staging system


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Sites of metastasis

7ier

7ung

'rain

'ones

1ia blood

7ymph nodesAbdominal wall

8eres

1essels

1ia lymphaticsPer continuitatem


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olecular 'iology < Pathology

$%$s arise from a series of histopathological and

molecular changes that transform normal epithelial cells

&ntermediate step is the adenomatous polyp

Adenoma-$arcinoma-Se=uence (1ogelstein < >in?ler)

Polyps occur uniersally in "AP,

but "AP accounts for only 5+ of $%$s

Adenomatous Polyps in general population:+ at age *

.+ at age .


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(s a 0ery rare process in 6hich a normal cellis con0erted to a cancer cell 0ia multiple8steps o7 cellular e0olution: 6hichcorrespond to 0arious pre-neoplastic andneoplastic phenotypes and genotypes#

(nclude; hyperplasia: dysplasia: anaplasia:drug-resistance: immortality: in0asi0eness:

metastasis: etc

Carcinogenesis


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Multisteps carcinogenesis ofColon Ca (Vogelstein Model)


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MM' de7ects gi0e rise to )GF-beta '(( mutations: 6hich pre0entcell cycle inhibitor


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Thank You

bedah colorectal carcinoma

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