Methods and principles of surgical treatment of colon cancer

The earliest symptoms of colon cancer are generally not obvious, followed by abdominal distension, discomfort, indigestion-like symptoms, and then changes in bowel habits, such as increased bowel movements, diarrhea or constipation, and abdominal pain before defecation. When there is mucus in the stool or mucus, pus and blood in the stool, it is generally in the middle and late stages. Surgery is one of the main treatments for colon cancer, including radical surgical resection and palliative surgical treatment.

The treatment of colon cancer first emphasizes surgical resection, and focuses on combined preoperative chemotherapy, radiotherapy and other comprehensive treatments to improve the surgical resection rate, reduce the postoperative recurrence rate, and improve the survival rate.

Commonly used surgical treatments for colon cancer:

1. Left hemicolectomy

It is suitable for descending colon and splenic flexure cancer. Resection range: left half of transverse colon, descending colon, part or all of sigmoid colon, together with its mesentery and lymph nodes. After resection, the colon is anastomosed end to end or the colon is anastomosed end to end.

2. Right hemicolectomy

It is suitable for cancers of the cecum, ascending colon and hepatic flexure of the colon. The resection range: 15 to 20 cm of the terminal ileum, the cecum, ascending colon and the right half of the transverse colon, together with the associated mesentery and lymph nodes. Cancers of the hepatic flexure also require resection of most of the transverse colon and the lymph nodes of the right gastroepiploic artery group. After resection, the ileum and colon are anastomosed end-to-end or end-to-side (the colon ends are sutured closed).

3. Transverse Colon Resection

Applicable to transverse colon cancer. Resection range: transverse colon and its hepatic flexure and splenic flexure. End-to-end anastomosis of ascending and descending colon is performed after resection. If the anastomotic tension is too high, right hemicolectomy can be performed and ileocolic anastomosis can be performed.

4. Radical resection of sigmoid colon cancer

Depending on the specific location of the tumor, in addition to resection of the sigmoid colon, a descending colon resection or partial rectal resection may be performed, and a colo-colonic or colorectal anastomosis may be performed.

Principles of surgical treatment of colon cancer

1. Try to protect the pelvic autonomic nerves. In addition, due to the particularity of the colon, preoperative preparation for surgical treatment of colon cancer should include preoperative intestinal preparation in addition to routine preoperative preparation.

2. Surgical principles for patients with intestinal obstruction

After preoperative intestinal preparation, if the intestinal contents are significantly reduced and the patient's condition permits, a primary resection and anastomosis can be performed, but protective measures should be taken during the operation to minimize contamination. If the intestine is full and the patient's condition is poor, a colostomy can be performed on the proximal side of the tumor first, and a secondary radical resection can be performed after the patient's condition improves.

3. Cure as radically as possible. The first treatment of colon cancer is critical and directly related to the survival period and quality of life after surgery. Therefore, colon cancer surgery should be cured as radically as possible.

4. Principles of surgery that cannot be radically cured

When the tumor has extensive local infiltration or is fixed to surrounding tissues and organs and cannot be removed, if the intestinal tract is already obstructed or may soon be obstructed, a short-circuit surgery between the distal and proximal sides of the tumor can be used, or a colostomy can be performed. If there is metastasis to distant organs and the local tumor can still be removed, local palliative resection can be used to relieve symptoms such as obstruction, chronic blood loss, infection and poisoning.

At the same time, it should be noted that regular physical examinations should be conducted after colon cancer surgery, especially anti-cancer physical examinations. If there is any suspicion, timely examinations should be carried out to achieve early detection and early treatment. At the same time, patients should maintain a good attitude, and their families should also provide corresponding care and fight cancer together with the patients.