Optimized surgical tactics for localized colon cancer (literature review)

Abstract

Malignant tumors have long occupied a special place in medicine and many researchers in different areas focused their attention on these disorders. Particular attention should be paid to gastrointestinal tumors with colon cancer being the most common among them. Moreover, the incidence of colon cancer is constantly growing. Despite the extensive experience in surgical treatment for colon cancer, we are still in search for new optimal methods that can increase overall and relapse-free survival without increasing the incidence of intra- and post-operative complications that are always associated with the volume of surgery. Recently, there has been a stable trend towards organ-sparing techniques. Segmental resections have become widely used in patients with localized cancer of the left colon and are now considered as an alternative to traditional left hemicolectomy. These two techniques demonstrated no significant differences in long-term outcomes. Then segmental resections became widely used in patients with localized tumors of the right colon and middle third of the transverse colon. These surgeries demonstrated their efficacy and good long-term outcomes. As for caecal cancer, the literature on this subject is too scant to make any conclusions about the rationality and feasibility of ileocecal resections. This implies that the utility of the method and its potential implications should be evaluated in further studies, including prospective ones that will compare both short-term and long-term outcomes. This literature review analyzes anatomical and physiological characteristics of right and left colon tumors, outlines generally accepted standards of lymphadenectomy, and summarizes the information on novel surgical techniques for colorectal cancer.