What are the surgical methods for colon cancer

The scope of colon cancer surgery depends on the scope of lymph node dissection. The number of main arteries treated within the lymph node dissection determines the length of intestinal resection, which also determines the surgical procedure. Experts from the Cancer Hospital of the Chinese Academy of Medical Sciences will introduce the surgical methods for colon cancer.

(I) Local resection refers to the resection of part of the intestinal wall in the area where the tumor is located. It is suitable for early colon cancer, Dukes' A and part of A1 stage. The basic requirements are: ① resection of the entire layer of the intestinal wall, ② the distance between the resection margin and the tumor should not be less than 2.0 cm. For polypoid early colon cancer, high-frequency electrosurgical snare resection can be used for resection, and microcancer can be removed by high-frequency electrothermal forceps; for flat, depressed lesions, endoscopic mucosal resection (EMR) can be used.
(ii) Tumor bowel resection refers to the removal of a certain length of the intestine including the tumor. Generally, the upper and lower resection margins should not be less than 5.0 cm away from the tumor. It is suitable for tumors limited to the superficial muscle layer, i.e. Dukes' A and part of A2 stage.
(III) Radical surgery Radical surgery for colon cancer refers to the complete removal of the primary tumor and the removal of lymph nodes up to station X, while lymph node metastasis is limited to station X-1 or below in histological examination. Radical surgery for colon cancer with lymph node clearance up to 1, 2, and 3 stations is called D1, D2, and D3 surgery respectively. According to the number of main blood vessels removed, it can be divided into: surgery along one main blood vessel is called regional resection, such as ileocecal resection, transverse colectomy, and sigmoid colectomy; surgery that removes two main blood vessels is called hemisection, such as right hemicolectomy and left hemicolectomy; surgery that removes three main blood vessels is called extended hemisection, such as extended right hemicolectomy. Generally, the classic hemicolectomy can be D2 hemicolectomy. And extended hemicolectomy refers to D3 extended resection. The indications for D2 are Dukes, B and C1, and D3 surgery is limited to Dukes, C1 and C2.