Management of colon cancer(surgical).pptx

Colon Cancer Surgical Management, update.
Dr. Tadesse Habteyohannes
AAU, CHS
Colon cancer is among the largest cancers in the world and current treatment options, especially cure intent are a must. This slide will update on the current surgical recommendation for colon cancer based on location and stage. It also includes prognostic discriminants on the outcome of the disease.
If you have any questions you can reach me at
[email protected] or by phone [phone]

1. Management of colon cancer April 26, 2024, GC AAU, CHS

2. Colorectal cancer statistics, 2023 CA A Cancer J Clinicians, Volume: 73, Issue: 3, Pages: 233-254, First published: 01 March 2023, DOI: (10.3322/caac.21772) 46% 57% long-term trends in colorectal cancer incidence and mortality

3. Preoperative evaluation Candidates for Resection General Principles Colon Resection Special Considerations Introduction Outline of presentation Complicated Colon ca Prognostic Discriminants and Results

4. Surgical resection Extent of colectomy Goal of resection Examination of LN Predictor of outcome Introduction

5. Evaluation Preparation Preoperative evaluation

6. Preoperative Evaluation

7. Preoperative Tumor Localization

8. Preoperative preparation

9. Candidates for Resection

10. General Principles

11. Approach Exploration of the abdomen Techniques General Principles… Exploration of the abdomen Incisions should provide maximum exposure for the planned resection . Attention should be directed to ruling out the presence of metastatic disease Special attention is given to the liver and the pelvis. The use of paramedian incisions appears quite antiquated. For emergency operations, a midline incision seems the access of choice No-Touch Technique Developed due to concern about dislodging tumor cells A recent randomized controlled trial of conventional colectomy vs no-touch for colon cancer resection found no difference Disease-free survival Overall survival Recurrence-free survival in stages II and III colon cancer patients Extent of resection

12. General Principles… Extent of resection Extent of resection

13. General Principles… Extent of resection Extent of resection

14. General Principles… Extent of resection

15. General Principles… Extent of resection Extent of resection

16. General Principles… Extent of resection Extent of resection

17. General Principles… Extent of resection Extent of resection

18. Recommended colectomy based tumor on location Techniques Reconstruction Colon Resection

19. 1. Cecum and Ascending Colon Cancer

20. 1. Cecum and Ascending Colon Cancer … Technical Aspects

21. 2. Hepatic Flexure Colon Cancer

22. 3. Transverse Colon Cancer

23. 3. Transverse Colon Cancer…

24. 4. Splenic Flexure and Descending Colon Cancer Fig. Formal left hemicolectomy for descending colon tumor Fig- Segmental left hemicolectomy for splenic flexure tumor

25. 4. Splenic Flexure and Descending Colon Cancer…

26. 5. Sigmoid Colon Cancer Fig. 25.8 Sigmoid colectomy

27. 5. Sigmoid Colon Cancer…

28. Special Considerations

29. Surgical Resection for Colon Cancer in the Setting of Lynch Syndrome Fig. Subtotal colectomy

30. Invasion of Adjacent Viscera

31. Invasion of Adjacent Viscera…

32. Invasion of Adjacent Viscera…

33. Invasion of Adjacent Viscera…

34. Invasion of Adjacent Viscera…

35. Invasion of Adjacent Viscera…

36. Synchronous Carcinomas

37. Obstruction Perforation Bleeding Colitis Complicated Colon ca

38. Complicated Carcinomas

39. Obstruction

40. Obstruction…

41. Obstruction…

42. Obstruction…

43. Obstruction…

44. Obstruction…

45. Obstruction…

46. Stenting…

47. Perforation

48. Perforation…

49. Perforation…

50. Perforation…

51. Bleeding

52. Obstructive colitis

53. Prognostic Discriminants and Results

54. Prognostic Discriminants

55. Prognostic Discriminants…

56. Results

57. Survival rate for colon cancer

58. References NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) Colon Cancer Version 3.2023 — September 21, 2023 Gordon and Nivatvongs ’ Principles and Practice of Surgery for the Colon, Rectum, and Anus Fourth Edition The ASCRS Textbook of Colon and Rectal Surgery Fourth Edition Weiser MR, Gönen M, Chou JF, Kattan MW, Schrag D. Predicting survival after curative colectomy for cancer: individualizing colon cancer staging. J Clin Oncol. 2011 Dec 20;29(36):4796-802. doi:10.1200/JCO.2011.36.5080. Epub 2011 Nov 14. PMID: 22084366; PMCID: PMC3664036. Version 2.2022, 03/07/23 © 2023 National Comprehensive Cancer Network® (NCCN®), All rights reserved. © 2024 UpToDate, Inc. and/or its affiliates. All Rights Reserved.