Changes

===Endoscopy and Laparoscopy===

===Endoscopy and Laparoscopy===

Allow visualisation of the lesion. In addition, biopsies may be taken at this time, however, only small superficial samples can be obtained thus there can be significant variation in the interepretation of the findings. Open

Allow visualisation of the lesion. In addition, biopsies may be taken at this time. Open proctoscopes are more useful than fibreoptic scopes for colorectal lesions as direct visualisation of the mass is possible and deeper biopsies can be obtained. Nevertheless, often only small superficial samples can be obtained on biopsying the gut thus there can be significant variation in the interepretation of the findings.

===Exploratory Laparotomy===

===Exploratory Laparotomy===

If it has not been possible to make a definitive diagnosis using the above techniques then surgery is required. All abdominal tissues should be assessed and full thickness biopsies should be taken. Resection of the mass and intestinal anastomosis may be performed at this time.  

Definitive diagnosis requires an excisional biopsy. All abdominal tissues should be assessed and full thickness biopsies taken. Resection of the mass and intestinal anastomosis may be performed at this time.  

==Treatment==

==Treatment==

===Surgery===

===Surgery===

Resection and anastamosis is advised as primary treatment for intestinal adenocarcinoma. Complete excision can usually achieved, however extraserosal invasion or adhesions may cause difficulties. In the small intestine, stapling and suturing by hand have been shown to be equally efficient. Local excision of colorectal adenocarcinoma has a median survival time of 22 months while the use of stool softeners alone has a median survival time of 15 months. Perioperative complications include peritonitis and sepsis. There is significant perioperative risk associated with cats with small intestine adenocarcinoma with a high mortality rate within the first two weeks following surgery. However, after these two weeks long term control may be achieved. With large intestinal adenocarcinoma survival time after surgery alone has been reported as approximately 4.5 months.

Surgical excision is advised as primary treatment for intestinal adenocarcinoma. Extraserosal invasion or adhesions may cause difficulties and care must be taken to ensure there is no iatrogenic damage to the biliary and pancreatic ducts for duodenal lesions. In the small intestine, wide local resection (4-8cm margins) can usually be achieved via enterectomy and anastomosis. Stapling and suturing by hand have been shown to be equally efficient for this procedure. If appropriate regional lymph nodes should also be removed. Large margins may be more difficult to achieve for colorectal lesions due to access issues.  

 

Local excision of colorectal adenocarcinoma has a median survival time of 22 months while the use of stool softeners alone has a median survival time of 15 months.  

 

Perioperative complications include peritonitis and sepsis. There is significant perioperative risk associated with cats with small intestine adenocarcinoma with a high mortality rate within the first two weeks following surgery. However, after these two weeks long term control may be achieved. With large intestinal adenocarcinoma survival time after surgery alone has been reported as approximately 4.5 months.

===Adjuvant Chemotherapy===

===Adjuvant Chemotherapy===