Four types of extended radical surgery for colon cancer

Due to the continuity and relative separation of lymphatic drainage, different parts of the colon require different radical treatments. Overall, extended radical surgery for colon cancer can include the following four procedures.

Extended radical resection for right colon cancer

For cancers of the cecum, ascending colon, and hepatic flexure of the transverse colon, the ileocolic artery, the right colic artery, and the right branch of the middle colic artery should be ligated and cut off at the root, and the lymph nodes in these areas should be removed. At the same time, the lymph nodes around the roots of the superior mesenteric artery, the inferior mesenteric artery, the abdominal aorta and the inferior vena cava, the right common iliac artery, and the external iliac artery should also be removed. For cancers of the hepatic flexure, the lymph nodes in the hepatoduodenal ligament behind the greater curvature of the stomach and the pancreatic head should also be removed.

Extended radical resection for left colon cancer

For cancers from the splenic flexure of the transverse colon to the beginning of the sigmoid colon, the left branch of the middle colic artery and the descending colic artery are often ligated and cut off at the root. At the same time, the lymph nodes in these areas as well as the roots of the superior mesenteric artery, the inferior mesenteric artery, around the abdominal aorta, beside the left common iliac artery, and beside the left external iliac artery should also be removed. For cancers of the splenic flexure, the lymph nodes in the greater curvature of the stomach and the splenic hilum should also be removed.

Extended resection of transverse colon cancer

For cancer in the middle part of the transverse colon, the middle colic artery should be ligated and cut off at the root, and the lymph nodes in this area should be removed. At the same time, the lymph nodes in the greater curvature of the stomach, the lymph nodes at the root of the superior mesenteric artery, the lymph nodes beside the hepatic artery, the lymph nodes beside the splenic artery, and the lymph nodes at the lower edge of the pancreas should also be removed.

Radical resection of sigmoid colon cancer

For sigmoid colon cancer, the inferior mesenteric artery should be ligated and cut off at the root, and the lymph nodes at its root and the lymph nodes beside the superior hemorrhoidal artery should be removed. At the same time, the lymph nodes beside the abdominal aorta and the lymph nodes beside the left internal and external iliac arteries should also be removed.