👨‍⚕️ Dr. BOSS 的一般外科衛教室｜Episode 08：直腸癌手術

👨‍⚕️ Dr. BOSS 的一般外科衛教室｜Episode 08：直腸癌手術 Dr. BOSS’s General Surgery Health Classroom｜Episode 08: Rectal Cancer Surgery 副標 / Subtitle 👨‍⚕️ Dr. BOSS × 🐨 Koala | 直腸癌：早期篩檢與手術治療 👨‍⚕️ Dr. BOSS × 🐨 Koala | Rectal Cancer: Early Detection & Surgical Treatment --- 🟦 對話稿 Dialogue（中英對照） Koala： BOSS醫生，直腸癌和大腸癌有什麼不一樣嗎？ Doctor BOSS, what’s the difference between rectal cancer and colon cancer? BOSS 醫生： 直腸癌是發生在直腸末端的癌症，靠近肛門口。手術上因位置關係，除了切除腫瘤，也要注意肛門功能與排便控制。 Rectal cancer occurs at the lower end of the rectum, near the anus. Surgery must remove the tumor while preserving anal function and bowel control when possible. Koala： 手術會很複雜嗎？ Is the surgery complicated? BOSS 醫生： 直腸位置深且靠近重要神經，手術比大腸癌複雜，有時需使用腹腔鏡或機器手臂輔助，並可能搭配術前放射治療或化療縮小腫瘤。 The rectum’s deep location near critical nerves makes surgery more complex. Laparoscopic or robotic-assisted techniques are often used, sometimes combined with preoperative radiation or chemotherapy to shrink the tumor. --- 🟦 診斷篇 Diagnosis（中英對照） 症狀 / Symptoms 血便、排便習慣改變、排便不盡感、腹痛、貧血 Blood in stool, change in bowel habits, sense of incomplete evacuation, abdominal pain, anemia 檢查 / Examination 直腸鏡、組織切片、腹盆腔影像（MRI/CT）、血液腫瘤標記（CEA） Rectoscopy, biopsy, pelvic imaging (MRI/CT), tumor markers (CEA) --- 🟦 手術治療 Surgical Treatment（中英對照） 低位前切除 / Low Anterior Resection (LAR) 適合靠近直腸上端的腫瘤，切除腫瘤段落並接回腸管，保留肛門功能。 Suitable for tumors in the upper rectum; removes tumor segment and reconnects colon while preserving anal function. 腹會陰切除 / Abdominoperineal Resection (APR) 適合靠近肛門的腫瘤，需切除直腸與肛門，術後需永久造口。 For tumors near the anus, removes rectum and anus; permanent colostomy required postoperatively. 微創手術 / Minimally Invasive Surgery 腹腔鏡或機器手臂輔助，減少傷口、加快恢復，手術精準度高。 Laparoscopic or robotic-assisted surgery reduces incision size, speeds recovery, and increases precision. --- 🟦 術後照護 Postoperative Care（中英對照） 飲食與營養 / Diet & Nutrition 術後初期以流質或軟食，逐步恢復均衡飲食；若有造口需學習造口護理 Start with liquids or soft foods; gradually resume a balanced diet; colostomy care if applicable 排便訓練 / Bowel Training 術後可透過調整飲食、規律排便與藥物，恢復排便功能 Use diet, scheduled bowel habits, and medications to restore bowel function 傷口照護 / Wound Care 注意切口及會陰部清潔，避免感染 Keep incision and perineal area clean to prevent infection 復發監測 / Follow-up 定期影像學與腫瘤標記檢查 Regular imaging and tumor marker follow-up --- 🟦 小知識 Mini Note（中英對照） Koala： 直腸癌手術後還能正常排便嗎？ Can normal bowel function return after rectal cancer surgery? BOSS 醫生： 多數情況下，若保留肛門且進行排便訓練，排便功能可逐步恢復。但若需永久造口，需學習造口護理，生活仍可正常進行。 In most cases, if the anus is preserved and bowel training is done, function gradually returns. For permanent colostomy, proper care allows a normal life. --- 🟦 小貼士 Quick Tip 中文：早期篩檢（如大腸鏡）能發現癌前病變，降低手術難度與復發風險。 English: Early screening (e.g., colonoscopy) can detect precancerous lesions, reducing surgical complexity and recurrence risk.