PREOPERATIVE CLINICAL:
-Systemic symptoms
9. Weight: . . kg. 10. Height: . . . cm. 11. Skin, mucous membranes( ).
12. General condition( )
- Functional Symptoms
13. Fresh bloody stools ( ). 14. Mucus-bloody-nose stools ( ). 15. Loose stools ( ).
16. Constipation ( )
17. Flat stool ( ). 18. Alternating diarrhea and constipation ( ). 19. Tension ( ).
20. Anal pain ( ) 21. Abdominal pain ( ). 22. Vomiting ( ).
23. Weight loss( ). 24. Anemia( ).
11: 1/ Pink skin and mucous membranes.
2/ Pale skin and mucous membranes. | 3/ Skin, mucous membranes | |
pale | ||
12 : 1/ Good 2/ Average | 3/ Poor | |
13,14,15,16,17,18,19,20,21,22,23,24 : 0/ No. 1/ Yes | ||
Maybe you are interested!
-
Research on the application of laparoscopic surgery to assist in resection of pancreatic head duodenum to treat ampullary tumors - 24 -
Research on the application of laparoscopic surgery in the treatment of rectal cancer - 16 -
Research on the application of laparoscopic surgery to assist in resection of pancreatic head duodenum to treat ampullary tumors - 22 -
Research on the application of smartphone utility software to evaluate traffic noise and road surface iri index - 14 -
Research on the application of smartphone utility software to evaluate traffic noise and road surface iri index - 15
- Physical Symptoms
25. Abdominal examination ( ). 26. Abdominal examination ( ). 27. Degree of tumor mobility through abdominal examination ( ) 28. Rectal examination ( ). 29. Degree of tumor mobility through rectal examination ( )
25 :
1/ Normal abdomen. 2/ Bloated abdomen. 3/ Boat-shaped abdomen
30. Gross appearance of the tumor through colonoscopy( ). 31. Degree of invasion of the colon circumference( )
27.29 : 0/ Cannot feel U.
26.281/ Can touch U 1/ Good mobility | 2/ Poor mobility. | 3/ | ||
Not mobile. 30 : 0 / Cannot feel U. | 1/ Warts. | 2/ Ulcer form. | 3/ | |
Form 31 : 3/4 | infiltration 0/ Cannot touch U. 4/ Occupy 4/4 | 1/ Occupy 1/4. | 2/ Occupy 2/4. | 3/ Occupy |
PRE-OPERATIVE PARACLINICAL EXAMINATION:
- Hematology and biochemistry tests
32 . Blood group ( ). 33 . Red blood cells ( ). 34 . White blood cells ( ). 35 . HGB ( ). 36 . Hct ( ) 37 . Blood urea ( ). 38 . Blood creatinine ( ). 39 . Blood protein ( ). 40 . SGOT ( ). 41 . SGPT ( )
42 . CEA ( ). 43 .CA19-9 ( ). 44 . CA 125( )
- Abdominal ultrasound
45. Thickening of the rectal wall( ). 46. Loss of the structure of the rectal lining( ). 47. Invasion of organs surrounding the rectum( ), if any, clearly state the invaded organs: . .
. . . . . . . . . .
48 .Ascites( ) 49 .Blood in the intestine( ) . 50 .Fluid in the intestine( ) . 51 Increased intestinal motility( ) 52 .Hydronephrosis( ) . 53 .Ureteral dilatation( ) . 54 .Peritoneal metastasis( )
55. Abdominal lymph node metastasis ( ), if any, clearly state the location of the metastatic lymph nodes: . . . .
. . . . . . . . . 56. Metastasis to abdominal organs( ), if any, clearly state the metastatic organs: . . . . . . . . . . . . . . .
-Upright chest X-ray
57. Lung disease on chest x-ray ( ), if any, please specify: . . . . . .
. . . . . . . . .
58. Lung metastasis( )
45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58 : 0/ No. 1/ Yes
- CT scanner
59. CT scan( ). 60. Tumor distance from anal verge( )cm. 61. Tumor length( )cm. 62. Tumor shape( ). 63. Invasion of surrounding tissue( ), if any, please specify: . . . . . . .
64. Regional lymph nodes( ). 65. Metastatic lymph nodes( ), if any, please specify . . . . . . .
66. Hydronephrosis ( ). 67. Ureteral dilatation ( ). 68. Peritoneal metastasis ( ).
68a . Metastasis to abdominal organs ( ), if any, clearly state the metastatic organs: . . . . . . .
59, 63, 64, 65, 66, 67, 68,68a : 0/ No. 1/ Yes
62 : 1/ Verrucous form. 2/ Ulcerative form. 3/ Infiltrative form.
- Colonoscopy
69 . Rectal endoscopy( ) . 70 . Tumor distance from anal verge( )cm. 71 . Length of tumor( )cm.
72. Shape of the tumor( ). 73. Degree of invasion of the rectal circumference( )
69 : 0/ No. 72 : 1/ Warty form. 73 : 1/ Occupying 1/4.
1/ Yes
2/ Ulcerative form. 2/ Occupies 2/4.
3/ Infiltration form.
3/ Occupy 3/4
4/ Occupy 4/4
- Cystoscopy
74. Cystoscopy( ). 75. Bladder invasion( )
74, 75 : 0/ No. 1/ Yes
CHARACTERISTICS OF TUMOR DURING AND AFTER SURGERY:
76. Distance from U to anal verge( )cm. 77. Mobility of U ( )
78. Degree of invasion of rectal circumference( ).
79. Invasion of surrounding tissue( ), if any, clearly state the invaded tissue
..........................................................................................................................
80. Metastasis to abdominal organs( ), if any, clearly state the metastasized organs
..........................................................................................................................
81. Regional lymph nodes( ). 82. Metastatic lymph nodes( ), if any, clearly state the location of metastatic lymph nodes
. . . . . . . . . . 83.Macroscopic appearance of U ( ) 84.Microscopic appearance of U ( ),
Other types: . . . . . . . . . 85 .Differentiation( )
86. Degree of invasion ( ). 87. Regional lymph node metastasis ( )
77 : 1/ Good mobility 2/ Poor mobility. 3/ Not mobile.
78 : 1/ Occupy 1/4. 2/ Occupy 2/4. 3/ Occupy 3/4 4/ Occupy 4/4
79, 80, 81, 82 :
0/ No.
1/ Yes
83 :
84 :
1/ Warts.
2/ Ulcer form.
3/ Infiltration form.
1/ Papillary carcinoma.
2/ UTBM pipeline.
3/ UTBM
mucous gland
4/ Signet ring cell carcinoma. Small cell carcinoma.
7/ Squamous cell carcinoma.
10/ Sarcoma.
5/ Undifferentiated UTBM.
6/ UTBM cell
8/ Squamous cell carcinoma.
11/ Other
9/ Bone marrow cancer.
85 : 0 / Unable to grade histologically.
3/ Poor differentiation.
1/ Well differentiated. 2/ Moderately differentiated.
4/ Undifferentiated
86 : 1/ Non-invasive (Carcinoma in situ-Tis). 2/ Invasion to the lower layer
mucosa
3/ Invasion to the muscle layer. still in the serosa).
4/ Invasion to the serosa(
5/ Invasion destroys the serosa (outside the serosa). 6/ Muscle invasion
Neighborhood
87 : 0 / No lymph node metastasis.
3/ Not recorded
1/ Metastasis to 1-3 lymph nodes.
2/ Metastasis > 4 lymph nodes.
CLINICAL STAGE :
88 . T ( ). 89 . N ( ). 90 . M ( ). 91 . GĐLS ( )
88. T - Primary tumor
1/ Tx: Primary tumor cannot be assessed
2/ To: No primary tumor
6/ T3: Tumor invades to
serous membrane
89. N - Lymph nodes in the region
1/ Nx: Not rated yet
lymph nodes in region 2/ No: No metastasis
regional lymph nodes
3/ N1: Metastasis to 1-3 lymph nodes in the area
4/ N2: Metastasis to 4 or more lymph nodes
5/ N3: Lymph node metastasis along the arterial trunk
rectal
90. M - Distant metastasis
1/ Mo: No distant metastasis 2/ M1: Distant metastasis
3/ Tis: Carcinoma in situ
(pre-invasive cancer).
4/ T1: Tumor invades the layer
submucosal 5/ T2: Tumor invades the muscle layer
7/ T4: Tumor invades to
neighboring agencies
91. GDLS :
0/ Stage 0: Yes, No, No
1/ Phase I:
T1-T2, No, Mo 2/ Phase II:
T3-T4, No, Mo 3/ Phase III:
Any T,N1,N2,N3,Mo
4/ Stage IV:
Any T, Any N, M1
SURGERY :
92. Date of surgery: / / 93. Anesthesia method ( ). 94. Laparoscopic surgery method ( ). 95. Characteristics of surgery ( ). 96. Number of trocars ( ). 97. Suturing technique ( ).
98. Dissection method( )
93 : 1/ NKQ anesthesia. 2/ NKQ anesthesia + NMC anesthesia
94 : 1/Resection of the colon. 2/Resection of the colon with Pull-through anastomosis. 3/PT Miles
95 : 1/ Radical.
97 : 1/Connect the machine.
2/Not radical. 2/Connecting hands.
96 : 1/ 4 trocars.
2/ 5 trocar
98 : 1/ Cut the blood vessels first.
2/ Cut U first.
PROGRESS DURING AND AFTER SURGERY :
99. Conversion to open surgery ( ). 100. Reason for conversion to open surgery ( ). Other reasons, please specify:. . . . . . . . 101. Complications during surgery ( ). 102. Postoperative complications ( ). 103. Late complications ( )
99. Conversion to open surgery: 0/ No
102, 103. Postoperative complications Late complications: | |||
1/ Yes | 0/ No complications | 8/ HMNT drop | |
101. Internal accident surgery: | 1/ Bleeding belly | 9/ Necrosis HMNT | |
100 .Reason: | 0/ No complications | 2/ Anastomotic bleeding | 10/ Narrow HMNT |
0/ No conversion to open surgery | 1/ Bleeding | 3/ Connection platform | 11/ Sa HMNT |
1/ Large tumor, wide invasion | 2/ Damage to adjacent organs | 4/ Peritonitis due to visceral perforation | 12/ Hernia through trocar |
2/ Unstoppable bleeding | 3/ Death | 5/ Intestinal obstruction 6/ Surgical site infection | 13/ Death |
3/ Other reasons | 7/ Residual abscess | 14/ Other | |
104. Postoperative pain level ( ).
105. Time to use pain medication after surgery ( )
106. Time of defecation ( ). 107. Time of recovery ( ) days.
104. Postoperative pain level: 105. Duration of pain medication after surgery:
0/ Painless 0/ No use
1/ Mild pain: Pain when moving or coughing but does not affect daily activities and sleep, may not require painkillers
2/ Moderate pain: Affects daily activities and sleep, pain increases when moving or coughing, pain relievers are needed
3/ Very painful: Continuous pain in all positions, greatly affecting daily activities and sleep, requiring painkillers
108.Discharge date: / / .
1/Use on the first day. 2/Use until the second day. 3/Use until the third day.
4/Use until day 4. 5/Use until day 5. 6/Use >5 days
106. Time of bowel movement: 1/Before 48 hours.
2/From 48-72 hours.
3/After 72 hours
109 .Date of recurrence: / / . 110 .Location of recurrence ( ). 111 . Treatment of recurrence( )
112.Date of metastasis: / / . 113.Location of metastasis( ),other location(specify):
. . . . . . . . . 114 . Treatment of metastasis( ). 115 .Date of Death: / /
. 116 .Research date: / /
110. Location of recurrence
0/ No recurrence
113. Location of metastasis:
111 , 114 : Treatment of recurrence and metastasis:
0/ No metastasis
1/ Liver 2/ Lungs
3/ Peritoneum
4/ Bones
5/ Brain 6/ Ganglia
upper arm (T)
7/ Other locations
0/ No treatment
1/ Surgery 2/ Radiation therapy
3/ Chemotherapy
4/ PT radiotherapy
1/ On the spot 2/ On the spot-
Wide invasion
5/ PT chemotherapy 6/ PT
radiotherapy chemotherapy
Appendix 2: POSTOPERATIVE FOLLOW-UP INSTRUCTIONS
Time
CEA | Super abdominal sound | X-ray lung | CT scan belly | Take note uncle | |
3 months | x | x | x | ||
6 months | x | x | x | x | |
12 months (1 year) | x | x | x | x | |
18 months | x | x | x | ||
24 months (2 years) | x | x | x | x | |
36 months (3 years) | x | x | x | x | |
48 months (4 years) | x | x | x | x | |
60 months (5 years) | x | x | x | x | |
72 months (6 years) | x | x | x | x |
Appendix 3: LIST OF PATIENTS IN THE STUDY LIST OF PATIENTS WITH RECTAL CANCER UNDERGOING ENDOSCOPIC SURGERY AT HUE CENTRAL HOSPITAL
FROM APRIL 2007 TO MARCH 2013
STT
Full name | Year old | Date | Number of copies | Address | |
1. | Tran Thi Th. | 45 | 04/20/07 | 17485 | Fragrance of Vinh, Fragrance of Tea, TTH |
2. | Xom Ph. | 52 | June 18, 2007 | 27406 | At Sa Phang Thong, SAVA |
3. | Nguyen Thi O. | 62 | 04/07/07 | 30336 | Trieu Phong, QT |
4. | Nguyen V. | 75 | 04/08/07 | 37637 | Deer pond, Wealth, TTH |
5. | Phan Ngoc D. | 54 | 08/27/07 | 39895 | South Vietnam, Phu Hai, Phu Vang, TTH |
6. | Ha Thi Ph. | 51 | 09/25/07 | 44901 | Van Trach, Bo Trach, QB |
7. | Pham Van Th. | 61 | 10/01/07 | 45902 | Goodwill, Goodwill, Ng.An |
8. | Nguyen Hong Ph. | 56 | 04/04/08 | 15002 | Sub-region 5, Bac Nghia, Dong Hoi, Quang Binh |
9. | Van Thi Th. | 78 | 05/08/08 | 22908 | 40/210 Phan Chu Trinh, Phuoc Vinh, Hue City, TTH |
10. | Le Phuong N. | 42 | 05/13/08 | 22408 | 45 Song Hong, Phu Bai, Huong Thuy, TTH |
11. | Phan Ngoc O. | 52 | 13/08/08 | 39643 | Area 2, Khe Tre, Nam Dong, TTH |
12. | Nguyen Thi Ng. | 55 | 08/18/08 | 40363 | 1/9 Tran Hung Dao, Phu Hoa, Hue City, TTH |
13. | Duong Thi T. | 50 | 08/20/08 | 40877 | 07 Doi Cung, Hue City, TTH |
14. | Ho Diem Anh Th. | 14 | 08/27/08 | 42191 | 2/15 Nguyen Cong Tru, Hue City, TTH |
15. | Tran C. | 33 | 09/08/08 | 44186 | Village 2, Quang Ngan, Quang Dien, TTH |
16. | Le Thi Ngoc T. | 52 | 09/23/08 | 47126 | 317 Le Duan, Phu Thuan, Hue, TTH |
17. | Duong Van S. | 62 | 11/03/08 | 54735 | Tan Binh, Thuan An, Phu Vang, TTH |
18. | Truong H. | 61 | 06/03/09 | 23440 | 227 Chi Lang, Phu Cat, Hue, TTH |
19. | Hoang Thi H. | 74 | 03/04/09 | 16859 | Telecommunication, Phu Da, Phu Vang, TTH |
20. | Nguyen Thi D. | 82 | 04/16/09 | 19466 | Dong Hoi, QB |
21. | Ta Van H. | 71 | 04/22/09 | 20703 | Nam Cuong, Vinh Nam, Vinh Linh, QT |
22. | Tran S. | 54 | 05/05/09 | 23237 | Binh An, Thang Binh, Quang Nam |
23. | Hoang Van H. | 74 | 05/09/09 | 24160 | Xuan Phu, Hue City, TTH |
24. | Tran Thi B. | 76 | 05/21/09 | 26590 | Huong Toan, Huong Tra, TTH |
25. | Le Thi L. | 73 | 01/07/09 | 35840 | Village 8, Ha Trach, Bo Trach, QB |
26. | Le Thi Minh H. | 55 | 07/08/09 | 37286 | Ward 9, Dong Le, Dong Ha, District 1 |
27. | Vo Thi V. | 37 | 07/29/09 | 41668 | Spring, Spring Festival, Spring Festival, TTH |
28. | Nguyen Thi B. | 58 | 07/30/09 | 41878 | 73/15 Nguyen Hoang, Huong Long, Hue City, TTH |
29. | Nguyen Xuan T. | 63 | 07/31/09 | 41970 | Quynh Hong, Quynh Luu, Ng.An |
30. | Nguyen Quang V. | 44 | 08/26/09 | 47296 | Village 4, Duc Hoa, Tuyen Hoa, QB |
31. | Tran C. | 59 | 09/03/09 | 48000 | Village 4, Vinh Ha, Phu Vang, TTH |
32. | Huynh Van M. | 40 | 09/17/09 | 51525 | An Lo, Phong Hien, Phong Dien, TTH |
33. | Dang Dinh Th. | 71 | 10/05/09 | 55087 | 23 Nguyen Khuyen, Phu Nhuan, Hue City TTH |