SURGICAL MANAGEMENT OF COMPLICATED COLON CANCER
DOI:
https://doi.org/10.54890/.v5i5-6.366Abstract
The management of complicated colon cancer (locally invasive, obstructed, or perforated cancers) can pose diagnostic and therapeutic challenges to surgical management. Adherence to traditional surgical oncologic principles must often be balanced with the patients' clinical presentation and other parameters. While the goal of an R0 (no residual microscopic disease) resection must always be kept in mind, situations sometimes arise which can make this difficult to achieve. Recognition of complicated disease and availability of varied therapeutic modalities is important to ensure favorable patient outcomes. This review will discuss the surgical management of complicated colon cancer, with special focus on locally advanced disease. The study examines the question of optimizing surgical treatment and additional therapeutic manipulations for complicated colon cancer. The most promising and readily available advance in the management of patients with obstructing colon cancers is the endoluminal colonic stent. Newer stent delivery devices now make selected right colonic lesions accessible to endoluminal stenting, and can be utilized in select cases not suitable for surgical resection. Colonic stents can be used either as primary treatment for patients with obstructing tumors not amenable to resection or as a bridge to surgical resection. For patients who are “bridged” with endoluminal stenting, resection can be considered once the proximal colon has been adequately decompressed and, at surgeon preference, the patient can undergo a mechanical bowel preparation.
Keywords:
colon cancer, colonic stent, large bowel resection, endoluminal colonic stent.References
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