File name .JPG
File alt. text
Image should be px wide x px tall.
Select Image
home - Colon - Colorectal and Anal Cancer - Colorectal Cancer Surgery Written by Dr Sebastian Zeki

Knows the pathology of benign and malignant tumours of the colon
and rectum
Has awareness of the molecular genetics of colorectal
carcinogenesis and the adenoma-carcinoma sequence
Knows the range of predisposing conditions including inherited
syndromes and acquired colonic diseases
Knows the range of clinical presentation and the means of
diagnosis, investigation, management and follow-up
Knows the strategy for prevention including procedures for

Uses clinical assessment and selects investigations to reach a rapid
conclusion as to whether a patient might have colorectal cancer and
arranges timely investigation.
Refers the patient to the multi-disciplinary team CbD, mini-CEX,

Shows ability to react to possible diagnosis of malignancy in a timely

Communicates with patient and family in a sympathetic and
understanding manner, explains next steps, involves other health
professionals (including the GP) as appropriate

Colorectal Cancer Surgery

Goal of Surgery for Colorectal Cancer: -Complete removal of the tumour.-Removal of vascular pedicle feeding the affected colonic segment.-Removal of lymphatic drainage basin (need at least 12+ any other suspicious LNs, need 5cm resection margin).-En bloc resection of contiguous structures if tumour adhesion is present.-Mark with radioopaque clips if RT anticipated (don’t disrupt adhesion plane can seed, and place omentum in post-op bed). MorbidityProlonged ileus (7.5 %);Pneumonia (6.2 %);Failure to wean from the ventilator (5.7 %); UTI(5 %);30 hospital mortality 6%. Short-term bowel function — BO increas to 4x/day. Usually beomes normal after 6 month Laparoscopic Colectomy:Less pain, faster return of bowel function, and shorter hospital stay10-20% convert to open. Principles of Surgery For Colorectal Cancer Criteria for surgery instead of endoscopic resecton:Poorly differentiated histology.Lymphovascular invasion. Cancer at the resection or stalk margin. Invasion into the muscularis propria of the bowel wall (T2 lesion). Invasive carcinoma arising in a sessile (flat) polyp. Invasive carcinoma with incomplete polypectomy. Management of Cancer in a Polyp: -If obstructed need temporary colostomy-If perforated usually divert-Ostomy closure when patient stable and if no chemo planned -Colonoscopy if bowel not adequately inspected at op-Bowel prep and oophorectomy not needed Indications For laporoscopic surgery:Nodiseaseinrectumorprohibitiveabdominaladhe-sions.Noadvancedlocalormetastaticdisease.No acutebowelobstructionorperforationfromcancer.Thoroughabdominalexplorationisrequired.Considerpreoperativemarkingofsmalllesions. Written by Dr Sebastian Zeki

Related Stories

SCG2 is a Prognostic Biomarker Associated With Immune Infiltration and Macrophage Polarization in Colorectal Cancer

A Long-Survival Case of Lower Rectal Cancer with Unresectable Liver Metastases Treated with FOLFOXIRI plus Bevacizumab(BEV)

A Case of Squamous Cell Cancer of the Anus Treated with Chemoradiotherapy

Laparoscopic Left Hemicolectomy for Advanced Descending Colon Cancer in Patient with Idiopathic Pulmonary Arterial Hypertension-Report of a Case

Changes in Renal Function and Feasibility of Adjuvant Chemotherapy for Colorectal Cancer Patients with Diverting Ileostomy after Ileal Pouch-Anal Anastomosis