Perioperative management - Hemicolectomy right, open - general and visceral surgery
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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.
- Pronounced peritoneal metastasis preventing sufficient mobilization the colon for subsequent anastomosis.
Preoperative diagnostic work-up
- 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
- Vascular/nerve injury
- Secondary bleeding
- Injury to adjacent organs
Special aspects of informed consent
- Anastomotic failure
- If anastomosis is not possible: Ostomy
Operating room setup
Special instruments and fixation systems