Radical resection
The volume is determined by localization: right-sided hemicolectomy for tumors of the cecum and ascending colon, left-sided - descending and sigmoid; the vessels are divided at the base, the complex is removed en bloc with a complete mesocolonectomy - the standard to ensure adequate lymph node dissection (12+ nodes for staging). The anastomosis is formed with staplers and checked for leaks. Early activation and nutrition, drainage 1–2 days; histology after 7–10 days is discussed with the oncologist to decide on chemotherapy. Observation - colonoscopy and CT scan as scheduled.
Indications
- tumors of the right or left half of the colon - radical resection;
- complicated diverticulosis, ischemic and inflammatory lesions of the intestinal segment;
- the need for temporary or permanent diversion of intestinal contents (stoma) in case of obstruction, fistulas, peritonitis, before/after resections;
- large polyps that cannot be removed endoscopically.
Principles of laparoscopic colon surgery
Laparoscopic bowel resection is performed according to oncological standards: ligation of vessels at the base, removal of a segment with mesentery and lymph nodes en bloc (CME), extraction through a mini-incision in a container, hardware anastomosis. Compared to open surgery, there is less pain and intestinal paresis, earlier nutrition and discharge, with equal oncological radicality. Before surgery - colonoscopy with biopsy, MSCT staging; after - histology with the number of lymph nodes determines the need for chemotherapy.
Benefits of laparoscopy
Laparoscopic access is the standard of modern abdominal surgery: instead of a 10–20 cm incision, 3–4 punctures are left, the pain after surgery is much less, the patient gets up on the day of surgery and is discharged after 1–2 days, the risk of wound infection, hernias in the scar and adhesions is several times lower, and the enlargement of the camera allows you to operate more accurately. In the clinics below, operations are performed by surgeons with extensive laparoscopic experience; hospital (SKD) is included in the price according to the price list.
