What is Colan Cancer?

Colon cancer is 3rd most common cancer in world and 4th most common cancer in India according to GLOBOCAN 2020. Usually it presents at age above 50 years. It can run in families and certain genetic mutation (APC, MMR) can also cause this cancer.

Discussing here case of 65 Years old lady , with hypertension and Ischemic heart disease (past history of coronary stenting) as co-morbids presented with complaints of abdominal pain diagnosed to have Non metastatic carcinoma sigmoid colon. She underwent laparoscopic Anterior resection and colo-rectal stapled anastomosis. On POD2, she was mobilised and started oral clear liquids to semisolid diet by POD6. Patient was discharged on POD7. Post operative histopathology report came as pT3N1. Patient advised adjuvant chemotherapy.

Hemicolectomy can be done open/laparoscopic/robotic approach. Oncological outcome does not differ between each approaches, minimal invasive surgery will have better patient related outcomes like,

⁃ less postoperative pain

⁃ Less blood loss

⁃ Faster recovery

⁃ Early mobilisation

⁃ Reduce hospital stay

⁃ Smaller incision

⁃ Less chance of hernia formation

⁃ Better visibility of pelvic structures

At Anand Cancer Hospital, Surat ,

Dr JAYESH SHAH, laparoscopic surgical oncologist doing minially invasive colon and rectal cancer surgeries since 2006.

Intra-operative images:

Image 1: Tumour at Sigmoid colon adherent to left lateral abdominal wall

Image 2: Multiple enlarged nodes at main trunk of inferior mesenteric artery and precaval, para-aortic region - all nodes cleared

Image 3: Inferior mesenteric artery ligated at origin

Image 4: Distally rectum is devided with linear stapler after taking adequate distal rectal margin

Image 5: Proximal colon with mass taken out from separate suprapubic incision and proximal colon cut after taking adequate proximal margin from mass

Image 6: Anvil of circular stapler inserted and buttress suture around it taken with proline sutupack

Image 7 and 8: Anvil then fixed into shaft of stapler and colo-rectal stapled anastomosis done with circular stapler no.31, post firing of stapler no air leak and both doughnuts were intact

Image 9 and 10: Main specimen of sigmoid mass excised in toto with complete mesorectal excision.

Dr. Jayesh R. Shah