Colon cancer

Abstract

The primary treatment of localized colon adenocarcinoma is surgical resection, and the operative procedures have been designed to maximize the chance of cure. Miles’ theory was that wide excision and regional lymphadenectomy would result in the highest cure rate from the locally invasive and regional metastatic aspects of colon carcinoma [1]. Therefore, the operative techniques have focused on the regional arterial blood supply of the colon. The regional artery has defined the extent of mesenteric, lymphatic, and colonic resection. Other intraoperative considerations that may influence survival include the no-touch technique and intraluminal spread of exfoliated tumor cells, and have been reviewed [1]. There are two recent advances in colon cancer management that influence the surgeon’s approach to this disease. First, effective postoperative adjuvant chemotherapy is available for patients who are at high risk for developing recurrent disease. Second is the development of new laparoscopic instruments and techniques that permit colonic resections through small incisions, reducing postoperative pain, stress, and recovery time. These new aspects of colon carcinoma management re-emphasize the significance and rationale of adequate excision and lymphadenectomy, and warrant this review.