Right Colon Cancer Treatment

Right Colon cancer is cancer of the right side of the digestive tract. Most cases of colon cancer begin as small, noncancerous (benign) clumps of cells called adenomatous polyps. Over time some of these polyps can become colon cancers. This is usually presented as growth. Based on the location of growth cancer can be classified as Right Colon cancer. Colorectal cancers have both strong environmental associations and genetic risk factors.

There are various varieties of colon cancer growth. Approximately 5% of all colorectal cancers are attributed to two inherited syndromes, Familial Adenomatous Polyposis, and Lynch syndrome. The most common type of colon cancer is Adenocarcinoma. All new cases should be universally screened for DNA mismatch repair/microsatellite status, and RAS/BRAF mutational testing when considering for prognostic and predictive of chemotherapy efficacy. In almost all patients, a diagnostic or screening colonoscopy is required for tissue biopsy pathological confirmation of colon carcinoma. Based on the type and location of cancer, the best treatment is tailored. Almost all cancers will need tissue diagnosis and a multidisciplinary team approach to treatment. This team comprises your surgeon, oncologist, radiologist, radiation specialist, and physician.

Surgery

The main goal for cancer surgery is the complete resection of the tumor and potential lymphovascular spread with a goal of a minimal negative proximal and distal margin of 5 cm for colon cancer.  The Circumferential/radial margin should be greater than 1 mm. The essentials of cancer surgery involve central vascular ligation of the feeding main artery and complete mesocolic resection of the involved colonic section. Oncologic resection requires the removal of 12 or more lymph nodes.

Tumors of the Right colon include the appendix, cecum, ascending colon, and hepatic flexure. All require right colectomy with ligation of the right colic artery at its origin. The right branch of the middle colic artery and ileocolic artery are also ligated. This procedure is completed with mid-transverse colon anastomosis. 

Extended right colectomy also involves the ligation of the middle colic artery at its origin in addition to steps involving right colectomy. This procedure is completed with ileo-descending colon anastomosis. There are two types of surgeries that are offered. Open colectomy and the other most common type of surgery is Laparoscopic colectomy. Broadly these surgeries based on the technique can be classified as OPEN SURGERY and MINIMALLY INVASIVE SURGERY. Based on the location of the surgery or the type of colon removed it is called right colectomy or extended right colectomy for right-sided tumors.

OPEN SURGERY- Open Colectomy

Open surgery involves open technique. Here an incision is made in the middle of the abdomen called a LAPAROTOMY incision. The abdomen is entered and the colon with growth is found and evaluated. The principle of colon cancer surgery not only involves removing the growth but also removing the draining lymph nodes and removing the surrounding structures or organs that are attached to cancer which is called En-Bloc resection. After the resection is completed, continuity of the gastrointestinal tract is maintained with anastomosis. 

Open surgery is usually more painful than minimally invasive surgeries. But there are various medications that we use to help you have better pain control.

For this surgery, you may need a complete blood count (CBC), chemistry profile, PT, and PTT. Depending on your medical history, we may require additional testing: chest X-Ray, EKG, medical clearance from your primary care physician, cardiac clearance from your cardiologist, additional blood work, and finally Anesthesiology clearance.

We recommend that you have your blood work done before having the surgery performed. If this is not possible, please notify the surgical scheduling team at 8884200030.

MINIMALLY INVASIVE SURGERY- Laparoscopic Colectomy

Laparoscopic surgery involves a minimally invasive technique. Here we make small 5 mm incisions on the side of the abdomen depending on the location of the colon cancer and small 10 mm incisions near or at the umbilical area. The abdomen is entered and the colon cancer is identified. The growth with the draining lymph nodes and or surrounding tissue or organs if necessary are removed. The continuity of the gastrointestinal tract is maintained with anastomosis.

Laparoscopic surgeries are usually less painful than open surgeries. We still give you pain medications and nerve blocks so that you feel comfortable and are able to walk about six hours after the surgery.

For this surgery, you may need a complete blood count (CBC), chemistry profile, PT, and PTT. Depending on your medical history, your physician may require additional testing: chest X-Ray, EKG, medical clearance from your primary care physician, cardiac clearance from your cardiologist, additional blood work, and finally Anesthesiology clearance.

We recommend that you have your blood work done before having the surgery performed. If this is not possible, please notify the surgical scheduling team at 8884200030.

Patient education

BEFORE SURGERY

Please refer to the instructions below in preparation for your surgery. Proper preparation is essential to obtain the best surgical experience and results. Please note that failure to follow these instructions may result in rescheduling your surgery. Our team will contact each patient directly and will be available to answer any additional questions about surgery, scheduling and instructions.

PRE-OPERATIVE TESTING

You may need a complete blood count (CBC), chemistry profile, PT, PTT. Depending on your medical history, your physician may require additional testing: chest X-Ray, EKG, medical clearance from your primary care physician, cardiac clearance from your cardiologist, blood work and anesthesiology clearance.
We recommend that you have your blood work done at the hospital where you are having the surgery performed.

Please download the instructions below if you need any further instructions, please notify the surgical scheduling team at 8884200030

why us?

Our minimally invasive Surgeons are well known internationally in their field. They are experts in the diagnosis and management of various conditions, and innovation of minimally invasive surgery techniques. Our team provides a personalized approach for each patient, offering advanced surgical solutions. Our surgeons educate physicians on innovative techniques through national,international presentations and web-based seminars.