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演講人:日期:癌癥手術(shù)治療原則英文目錄IntroductiontoCancerSurgeryPreoperationalAssessmentandPreparationIntraoperativePrinciplesofCancerSurgeryPostoperativeCareandComplicationsPreventionOncologicalPrinciplesinCancerSurgeryFollowupCareafterCancerSurgery01IntroductiontoCancerSurgeryCancersurgeryisaprocedureperformedtoremovecancertroublefromthebodyThepurposeofcancersurgeryistoidentifythetuber,reducetheriskofrecurrence,andimprovethepatient'sdiagnosisSurgerycanalsobeusedtodiagnosecancerbyopposingissuesamplesforbiopsyDefinitionandPurposeofCancerSurgeryCurvativesurgeryAimstocompletelyremovethetuberandanyaffectedsurroundingissuePalliativesurgeryFocusesonrelievingsymptomsandimprovingthepatient'squalityoflifecomparedtocuringthecancerReconstructivesurgeryPerformedtorestorethefunctionandappearanceoftheaffectedareaaftertutorremovalDebuggingsurgeryRemoveasmuchaspossibleofthetuberaspossibletoreduceitssizeandimprovetheeffectivenessofothertreatmentssuchaschemotherapyorradiationtherapyTypesofCancerSurgeryAdvancementtosurgicalprinciplesensuresthesafetyandeffectivenessoftheprocedureProperpatientselection,preoperativeplanning,andsurgicaltechniquearecriticalforachievingthebestpossibleoutcomeAttentiontodetailandsubstantialsurgicaltechniqueareessentialforminimizingcomplicationsandmaximizingthechancesofasuccessfulrecoveryPostoperativecareandfollow-uparealsoimportantcomponentsofsurgicaltreatment,ensuringthatthepatient'srecoveryprocessesaresmoothandanypotentialproblemsareidentifiedandmanagedpromptlyImportanceofSurgicalPrinciples02PreoperationalAssessmentandPreparationPhysicalExaminationAthroughphysicalexaminationisconductedtoassessthepatient'sgeneralhealthstatusandtoidentifyanysignsorsymptomsrelatedtothecancerDiagnosticImagingImagingtechniquessuchasX-rays,CTscans,MRI,andultrasoundareusedtovisualizethelocationandextentofthetutorLaboratoryTestsBloodtests,biopsies,andotherlaboratoryproceduresareperformedtoconfirmthediagnosisanddeterminethetypeandseverityofthecancerPatientEvaluationandDiagnosisStagingofCancerThepresenceofcancercellsindistanceorganizationsorissuesindicatethatthecancerhasmetastasizedandisinamoreadvancedstageMetastasisThesizeoftheTumoranditsproximitytovitalorganizationsorstructuresareassessedtodeterminethestageofthecancerTumorSizeandLocationThepresenceorabsenceofcancerinthelymphnodesisevaluatedtounderstandifthecancerhasspreadbeyondtheoriginalsiteLymphNodeInvolvement要點三SurgicalApproachThesurgicalteamdeterminesthebestapproachtoremovethetutor,consideringfactorssuchasthelocation,size,andstageofthecancer0102TeamCompositionAmultidisciplinaryteamofsurgeons,oncologists,radiologists,pathologists,andnutsisassembledtoensurecomprehensivecareandtreatmentforthepatientPreliminaryPlanningDetailedpreliminaryplanningiscarriedout,includingdiscussionswiththepatientandfamily,toensurethatallnecessarystepsaretakentominimizerisksandoptimizeoutcomes03SurgicalPlanningandTeamComposition03IntraoperativePrinciplesofCancerSurgeryEnsuringasterileoperationalfieldiscriticaltopreventpostoperationalinfectionsThisinvolvestheuseofsteriledrapes,gloves,andinstruments,aswellasstrictadherencetobasictechniquesthroughouttheprocedureSterilizationSurgicaldecisionsshouldbeplannedtominimizescalingandmaximizecosmeticoutcomesThismayinvolveconsideringthelocationandorientationofthedecision,aswellastheuseoffeaturesandothertechniquestooptimizeheatingAestheticalTechniqueSterilizationandAestheticTechniqueGentlehandlingofissuesisessentialtominimizetraumaandpreservefunctionThisincludestheuseoffineinstrumentsandcarefulsectiontechniquestoavoiddamagingsurroundingstructuresTitleHandlingControllingbleedingduringsurgeryiscrucialtomaintainaclearoperationalfieldandminimizebloodlossThismayinvolvetheuseofclamps,sutures,orotherhomeostaticagentstoachievehomeostasisHemistasisTissueHandlingandHemostasisRemovaloflymphnodesmaybenecessarytostagethecancerandassessthespreadofdiseaseThisinvolvesthecarefulsectionofsimplenodesandsurroundingissuestoensurecompleteremovalLimphNodeDissectionAssessingtheTumor'sresponsetosurgeryisimportantforplanningfurthertreatmentThismayinvolveexaminingtheexpectedtuberforsignsofmalice,suchassize,shape,andinvasionintosurroundingissuesAdditionally,pathologicalexaminationofthetutorcanprovideinformationaboutthetypeofcancer,itsgrade,anddiagnosesTumorResponseLimphNodeDissectionandTumorResponse04PostoperativeCareandComplicationsPreventionEffectivepaintmanagementiscriticalforpatientcomfortandrecoveryThisincludestheuseofanalytics,opioids,andnonpharmacologicalmethodssuchasrelaxationtechniquesProperwoundcareisessentialtopreventinfectionandpromotehealingThisinvolvesregularcleaninganddressingchanges,aswellasmonitoringforsignsofinflationorinfectionSurgicaldrainsmaybeplacedtoremovefluidorairfromthesurgicalsitePropertymanagementofthesedrainsisimportanttoensuretheireffectivefunctionsandpreventcomplicationsPainControlWoundDressingandCareDrainageManagementPainManagementandWoundCareEarlyAmbulation01EncouragingpatientstoambushassoonaspossibleaftersurgerycanhelppreventcomplicationssuchasdeepveinthrombosisandpulmonaryembolismPhysicalTherapy02Physicaltherapyplaysakeyroleinhelpingpatientsregionstrength,flexibility,andrangeofmotionfollowingsurgeryOccupationalTherapy03OccupationaltherapycanassistpatientsinregisteringtheirabilitytoperformdailyactivitiesandreturntoworkorothermeaningfuloccupationsEarlyMobilizationandRehabilitationClosemonitoringofvitalsignssuchasheartrate,bloodpressure,andrespiratoryrateisessentialtodetectanypotentialopportunisticcompositesVitalSignsMonitoringRegularlaboratorytestsmaybeorderedtomonitororganicfunctions,electrolytebalance,andotherimportantphysiologicalparametersLaboratoryTestsImagingstudiessuchasX-rays,CTscans,orMRImaybenecessarytoassessthesurgicalsiteanddetectanypotentialapplicationsImagingStudiesRegularfollowupappointmentswiththesurgicalteamareimportanttomonitorprogressandaddressanyconcernsorissuesthatmayariseduringrecoveryFollowupAppointmentsMonitoringforApplications05OncologicalPrinciplesinCancerSurgeryAimforNegativeMarginsTheprimarygoalofsurgicalrecoveryistoremovetheentiretuberwithamarginofhealthissue,ensuringnocancercellsremainRadicalRestorationInsomecases,radialrestorationmaybenecessarytoremovethetuberandsurroundingissuesororganizationstoachievenegativemarginsMinimizeTumorManipulationSurgesaimtominimizethemanipulationoftheTumorduringsurgerytoreducetheriskofcancercelldissectionCompleteTurboRestorationIntraoperativeAssessmentSurveysmayperformintraoperativeassessmentofmargins,suchasinfrozensectionanalysis,toensurenegativemarginsareachievedPostoperativeReexaminationIfinitialmarginsarepositiveorclosed,reexaminationandadditionalsurgerymaybenecessarytoachievenegativemarginsUseofImagingTechniquesImagingtechniquessuchasMRI,CT,andultrasoundmaybeusedtoassesstumormarginsandguidesurgicalrecovery010203MarginAssessmentandReexaminationAdjustChemotherapyandRadiotherapyAdjustchemotherapy,suchaschemotherapyandradiotherapy,maybeusedaftersurgerytoeliteanyremainingcancercellsandreducetheriskofrecurrenceNeoadjuvantTherapyInsomecases,neoadjuvanttherapy(treatmentbeforesurgery)maybeusedtoshrinkthetuberandmakesignificantrecoverymorefeasibleMultimodalTreatmentApproachSurgicalrecoveryisoftencombinedwithothertreatmentmodalities,suchasminimal,hourly,ortargetedtherapy,toprovidethebestpossibleoutcomeforthepatientAdjuvantTherapyandMultimodalTreatment06FollowupCareafterCancerSurgeryRegularphysicalexaminationsTheseshouldbescheduledatregularintervalstomonitorforanysignsofrecurrence,suchaslumps,paint,orchangesinbodyfunctionsDependentonthetypeofcancer,imagingtestssuchasX-rays,CTscans,MRIs,orPETscansmaybeusedtodetectanyabnormalitiesinthebodyCertainbloodtestscandetectthepresenceofcancercellsormarkersthatmayindicatearecurrenceImagingtestsBloodtestsSurveillanceforRecurrence010203CounselingandtherapyCancersurvivorsmaybenefitfromcounselingortherapytohelpthemcoverwiththeemotionalandpsychologicaleffectsofthedi
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