Perioperative management - Hemicolectomy right, open

Restoring continuity in metastatic cancer of the right colon to avoid impending ileus and iostomy.

Contraindications in palliative hemicolectomy:

• Markedly reduced general condition due to metastatic malignancy.

Technical contraindication:

• Pronounced peritoneal metastasis preventing sufficient mobilization the colon for subsequent anastomosis.

• General preoperative diagnostics to assess patient suitability for anesthesia: here findings normal for age.
• Lab results, chest film, ECG, pulmonary function.
• Special preoperative diagnostics in colon cancer: Abdominal ultrasonography, colonoscopy to assess the remaining colon.
• Special preoperative diagnostics in metastatic colon cancer: CT study of the abdomen and possibly the chest.

Generally not required.
Antegrade bowel cleansing (lavage) in nonobstructing tumor.

General risks of surgery

• Thrombosis
• Embolism
• Infections
• Vascular/nerve injury
• Secondary bleeding
• Injury to adjacent organs
  Special aspects of informed consent
• Anastomotic failure
• Peritonitis
• If anastomosis is not possible: Ostomy