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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Written by Yan Chun
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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.

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Is stage II-III colon cancer considered late stage?

Patients with stage II and III colon cancer are not yet considered to be in the classic advanced stages. Current oncology believes that colon cancer is categorized as stage IV and considered advanced when distant metastases occur. Common sites of metastasis for colon cancer include the liver, lungs, and bones. Stage II colon cancer patients do not have metastases to the pericolic lymph nodes, which is relatively early; stage III colon cancer patients have metastases to the pericolic lymph nodes, which is later than stage II, but as long as there are no distant metastases, it does not reach the advanced stage IV.

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Written by Sun Ming Yue
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What are the symptoms of bone metastases from colon cancer?

Colon cancer generally refers to a malignant tumor that grows on the colon and typically appears in middle-aged populations. If colon cancer is not treated promptly, it can easily lead to bone metastasis. The bone metastasis of colon cancer is similar to other tumor metastases. The symptoms such as chest pain or tenderness upon pressing could be caused by bone metastasis from lung cancer. In the early stages of colon cancer, there are generally no symptoms of bone metastasis. However, once the tumor metastasizes to weight-bearing bones, thoracic vertebrae, cervical vertebrae, or lumbar vertebrae, it can result in paralysis. Patients must seek timely medical examination and treatment at a hospital to prevent the cancer cells from metastasizing.

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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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What should be done after the complete removal of colon cancer?

After surgical removal of colon cancer, the postoperative treatment strategy should be determined based on the precise staging of the cancer according to the surgical pathology. If the colon cancer has invaded the mucosal layer and the submucosal layer, or the muscular layer, it is staged as stage I; postoperative adjuvant chemotherapy is not required, and regular follow-up is sufficient. If the colon cancer reaches stage II or III, postoperative adjuvant chemotherapy is needed to reduce the risk of postoperative recurrence and metastasis. Stage IV colon cancer does not fall under the aforementioned conditions of clean removal of the cancer.