Right-sided colonic carcinoma is treated surgically, if at all feasible. The aim is to resect the affected segment of bowel.
The patient is admitted 2-3 days before the operation in order to prepare the bowel. The colon is cleared of exogenous material using laxatives and/or enemas, and cleansed of infective organisms using broad spectrum, poorly absorbed antibiotics such as neomycin.
Care is taken to look for metastases. Liver function tests, a liver scan, chest X-ray, and barium enema are valuable pre-operative investigations. Evidence of metastasis may not prevent planned surgery. Blood transfusion may be necessary if the anaemia is severe.
The terminal ileum, ascending colon and hepatic flexure are removed by right hemicolectomy. The patient can usually resume normal activities after 6 weeks.
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