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Chapter 54 - Colon resection

from Section 17 - General Surgery

Published online by Cambridge University Press:  05 September 2013

Michael F. Lubin
Affiliation:
Emory University, Atlanta
Thomas F. Dodson
Affiliation:
Emory University, Atlanta
Neil H. Winawer
Affiliation:
Emory University, Atlanta
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Summary

Open or laparoscopic colon resection is performed for a variety of conditions, the most common of which are benign or malignant neoplasms (tubular or villoglandular adenoma, adenocarcinoma, carcinoid, lymphoma); complications of diverticular disease (perforation with peritonitis or abscess, stricture, bleeding); extensive traumatic perforations; angiodysplasia or arteriovenous malformation with lower gastrointestinal bleeding; and inflammatory bowel disease (ulcerative colitis, segmental colonic Crohn's disease, toxic megacolon). Less common indications for resection include volvulus of the sigmoid colon or cecum; thrombotic, embolic, or low-flow infarction; and premalignant conditions (familial polyposis, Gardner's syndrome).

Hemicolectomy for malignant neoplasms involves excision of the area of the tumor, at least 10 cm of normal proximal colon or small bowel, and 5 cm of normal distal colon as well as excision of the regional lymphatics that accompany the major vessels in the mesentery. In contrast, segmental resection for complications of diverticular disease, Crohn's disease, colonic volvulus, or infarction involves only grossly diseased bowel without excision of the regional lymphatics. Subtotal abdominal colectomy with ileorectostomy is performed for patients with non-familial synchronous scattered benign or malignant neoplasms. It is also used in some patients with megacolon secondary to obstructing neoplasms of the sigmoid or rectosigmoid colon or of the upper rectum, and for patients with non-localized diverticular bleeding. For patients with severe medically refractory ulcerative colitis, familial polyposis, or Gardner's syndrome, a near-total abdominal colectomy is preferred. This involves preservation of a seromuscular short rectal cuff and the sphincter muscles to preserve anal continence and the creation of an ileal pouch–anal anastomosis.

Type
Chapter
Information
Medical Management of the Surgical Patient
A Textbook of Perioperative Medicine
, pp. 522 - 524
Publisher: Cambridge University Press
Print publication year: 2013

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References

Dente, CJ, Tyburski, J, Wilson, RF et al. Ostomy as a risk factor for posttraumatic infection in penetration colonic injuries: univariate and multivariate analyses. J Trauma 2000; 49: 628–34; discussion 634–7.CrossRefGoogle Scholar
Guller, D, Jain, N, Hervey, S et al. Laparoscopic vs. open colectomy: outcomes comparison based on large nationwide databases. Arch Surg 2003; 138: 1179–86.CrossRefGoogle ScholarPubMed
Kemp, JA, Finlayson, SRG.Outcomes of laparoscopic and open colectomy: a national population-based comparison. Surg Innov 2008; 15: 277–83.CrossRefGoogle ScholarPubMed
Lacy, AM, Garcia-Valdecasas, JC, Delgado, S et al. Laparoscopy-assisted colectomy versus open colectomy for treatment of non-metastatic colon cancer: a randomized trial. Lancet 2002; 359: 2224–9.CrossRefGoogle Scholar
Luglio, G, Nelson, H.Laparoscopy for colon cancer: state of the art. Surg Oncol Clin N Am 2010; 19: 777–91.CrossRefGoogle ScholarPubMed
Pahlman, L.Treatment of colorectal cancer. Ann Chir Gynaecol 2000; 89: 216–20.Google ScholarPubMed
Senagore, AJ, Duepree, HJ, Delaney, CP et al. Results of a standardized technique and postoperative care plan for laparoscopic sigmoid colectomy: a 30-month experience. Dis Colon Rectum 2003; 46: 503–9.CrossRefGoogle ScholarPubMed
Weeks, JC, Nelson, H, Gelber, S et al. Clinical Outcomes of Surgical Therapy (COST) Study Group. Short-term quality-of-life outcomes following laparoscopic assisted colectomy vs. open colectomy for colon cancer: a randomized trial. J Am Med Assoc 2002; 287: 321–8.CrossRefGoogle Scholar

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