Is colon cancer surgery a major surgery?

Written by Sun Wei
Surgical Oncology
Updated on September 22, 2024
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Colon cancer surgery is considered a relatively major procedure, ranking as a class three or four surgery in general surgery. Generally, it involves the resection of the entire transverse colon or tumors located in other areas such as the ascending or descending colon, accompanied by the removal of surrounding lymph nodes, followed by intestinal anastomosis and digestive tract reconstruction. Post-surgery, comprehensive anti-tumor treatment is usually required. After colon cancer surgery, the main focus is on preventing intestinal leakage, which is a serious complication. Dietary intake needs to be gradually restored after surgery. Initially, the patient may only be able to consume liquid and easily digestible foods, gradually transitioning to semi-liquid and regular diets, while also paying attention to eating smaller, more frequent meals.

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Difference between colon polyps and colon cancer

Colon polyps and colon cancer both belong to organic tumors of the colon mucosa, but the fundamental difference is that colon polyps are mostly benign, while colon cancer is a malignant cancer of the intestines. Both colon cancer and colon polyps require examination by electronic colonoscopy for a definitive diagnosis, and further pathological examination is needed. After the detection of colon polyps, it is necessary to promptly perform radiofrequency ablation surgery under electronic colonoscopy. After the detection of colon cancer, it is necessary to complete relevant pelvic and systemic examinations, and after clarifying the local lesions, surgical removal is performed. Postoperatively, based on the size of the cancerous mass and the extent of the lesion, radiation therapy or chemotherapy may be required.

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Colorectal Cancer CT Manifestations and Differential Diagnosis

Early-stage colon cancer is difficult to clearly detect on a CT scan. In the moderate to late stages, colon cancer has more typical manifestations on CT, mainly characterized by thickening of the colon wall, irregular narrowing of the intestinal lumen, and stiffness of the intestinal wall. After enhancement, significant enhancement can be observed. The pericolonic fat space may appear blurred, and in the late stages, small lymph nodes can be seen, and even distant metastasis, most commonly to the liver, can be detected. It is necessary to differentiate colon cancer from colonic inflammation. Inflammatory lesions are usually more widespread and have typical clinical features such as fever and abdominal pain. It is also necessary to differentiate from lymphoma, as lymphomas also cause narrowing of the intestinal lumen but the narrowing is not eccentric and the intestinal wall remains soft, generally not leading to obstruction, whereas in late-stage colon cancer, colonic obstruction can be observed.

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What to do about liver metastasis from transverse colon cancer?

Liver metastasis in transverse colon cancer is relatively common, especially in cases where the disease has progressed. Because the transverse colon is located close to the liver region, tumors in this area can potentially metastasize to the liver via the lymphatic or blood circulation, or through local infiltration. In cases where the liver metastasis is localized, there is still an opportunity for surgical treatment involving a radical resection of the transverse colon cancer combined with partial hepatectomy. If there are multiple metastases in the liver, radical surgery may not be feasible. Initially, preoperative neoadjuvant chemotherapy or targeted therapy is performed. If the liver metastatic lesions can be reduced or disappear, there may still be a chance for surgical treatment afterwards.

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Colon cancer surgical methods

The surgical approach for colon cancer should be tailored based on the specific circumstances of the patient, involving a rational, comprehensive treatment strategy. The surgical principle is that early-stage cancers should undergo curative resection, while more advanced cancers should be treated with radical surgery or extended radical surgery. Once the treatment plan is determined, the choice of surgical methods should be made comprehensively based on the patient's specific conditions. For example, in the surgery of rectal cancer in the middle and lower segments, it should be considered whether to preserve the anus or perform abdominoperineal resection based on the tumor's biological characteristics, patient's age, overall health, and any concurrent diseases. It is not that there is one fixed type of surgery; the approach should be specifically tailored based on the detailed analysis of the issues at hand.

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What are the early symptoms of colon cancer?

The early symptoms of colon cancer mainly include discomfort and pain in the lower abdomen, which does not necessarily become more pronounced after eating and generally occurs intermittently. Some patients may also experience changes in stool shape, primarily manifested as narrower stools, or an increased frequency of bowel movements per day, leading to diarrhea. Some patients in the early stages may experience worsening of pre-existing constipation, or alternating symptoms of diarrhea and constipation. Some colon cancer patients in the early stages may experience bloody stools, or the presence of mucus, pus, and blood in the stool, which are some atypical gastrointestinal symptoms of colitis. Some patients may also experience nausea.