Ba Nhinh experienced prolonged diarrhea, poor appetite, and rapid weight loss. A colonoscopy at Tam Anh General Hospital TP HCM revealed an ulcerated, proliferative tumor narrowing the rectal lumen. A biopsy confirmed rectal adenocarcinoma.

Doctor Do Minh Hung, Director of the Center for Endoscopy and Gastrointestinal Endoscopic Surgery, assessed the tumor as deeply seated in the narrow pelvic region, close to critical nerve structures and the sphincter, making it challenging to access. The patient's anemia and debilitated state could increase the risk of complications and impact postoperative recovery. Therefore, doctors decided on neoadjuvant therapy before surgery to optimize conditions for the operation. The surgical goal was to remove the tumor while preserving the patient's bowel function, thus avoiding the need for a permanent colostomy.

Following 25 doses of radiation therapy, Ba Nhinh underwent Da Vinci Xi robot-assisted laparoscopic surgery to remove the tumor and the entire mesorectum. During the procedure, surgeons evaluated the tumor's invasiveness to determine the feasibility of preserving the anal sphincter.

A surgeon precisely controls the robot's arms in the deep, narrow pelvic region during Ba Nhinh's operation. *Photo: Tam Anh Hospital*

In addition to the rectal tumor, the surgical team identified several lymph nodes along the inferior mesenteric artery. Surgeons performed a lymphadenectomy, separated the rectum from the vaginal wall, resected the distal rectum below the tumor, and then connected the colon to the rectum using a stapling device. Ba Nhinh did not require a colostomy.

After surgery, Ba Nhinh recovered well, able to walk and eat from the first day, and was discharged after 5 days.

Post-treatment pathology results classified the case as stage 3B, indicating the tumor had invaded the muscular layer of the rectal wall, with two regional lymph nodes containing cancer cells. The proximal, distal, and circumferential margins were clear of cancer cells. Ba Nhinh will continue follow-up and adjuvant therapy as prescribed by her oncologist to reduce the risk of recurrence and metastasis.

Ba Nhinh's health recovered well after the surgery. *Photo: Hospital provided*

Globocan 2024 reported nearly 23,000 colorectal cancer cases in Vietnam, ranking it as the fourth most common cancer.

Early detection of colorectal cancer offers a significantly better prognosis compared to advanced or metastatic stages. Colonoscopy not only helps detect cancer but can also identify and remove precancerous lesions, contributing to disease prevention.

Doctor Hung recommends screening according to guidelines for individuals with high-risk factors, such as a family history of colorectal cancer or adenomatous polyps, those over 55 years old, or individuals with existing bowel conditions. When abnormal symptoms appear, including blood in stool, persistent changes in bowel habits, prolonged diarrhea or constipation, abdominal pain, or unexplained weight loss, patients should seek medical examination to determine the cause.

By Quyen Phan