Common complications of colon cancer surgery and their treatment

With the remarkable progress in modern anesthesia technology, modern surgical technology, intensive postoperative treatment, and modern antibacterial treatment, the surgical resection rate of colon cancer has increased significantly, and the surgical mortality rate has decreased significantly. The surgical mortality rate in major medical centers around the world has been controlled below 5%.

1. Intraoperative injury The overall incidence of intraoperative injury and the specific incidence of organ and tissue injury are difficult to be clinically calculated. Familiarity with the adjacent relationship between the colorectum and its surrounding tissues and a good surgical field can effectively reduce the damage to the surrounding tissue structures during surgery. If the tumor has extensively invaded the local area and has affected the surrounding tissues and organs, in order to achieve the purpose of radical cure, it is necessary to jointly remove the affected tissues and organs.

2. Intraoperative hemorrhage Intraoperative hemorrhage caused by vascular injury is the most important component of intraoperative injury. Improper treatment will cause intraoperative death of the patient. Accidental injury to the portal vein, inferior vena cava, and abdominal aorta during colon cancer resection can induce massive hemorrhage, but it rarely occurs in actual work. Intraoperative hemorrhage is more common in rectal cancer resection.

3. Anastomotic complications When signs of diffuse peritonitis caused by anastomotic leakage appear , the condition is extremely dangerous and is a surgical emergency. Central venous access and another intravenous access for blood transfusion should be established quickly. Broad-spectrum antibiotics should be used quickly. If blood pressure cannot be effectively maintained after rapid infusion, hydrocortisone and dopamine can be used as appropriate. Once the patient's vital signs are stable, laparotomy should be performed. In actual work, the timing of laparotomy is extremely difficult to grasp. Because the patient's condition is unlikely to improve without removing the contamination in the abdominal cavity, some authors recommend considering laparotomy if the symptoms do not improve after 1 hour of conservative treatment.