Colon. Cancer

Colon Cancer
Colon Cancer Surgery, Colon. Cancer

Latest Surgical Management of Left Colon Cancer

Latest Surgical Management of Left Colon Cancer: Techniques And Considerations Left-sided colon cancer, which includes malignancies in the sigmoid colon and the descending colon, is a prevalent condition that often requires surgical intervention as part of its treatment. Over the years, surgical techniques and approaches for left colon cancer have evolved significantly, leading to improved outcomes and quality of life for patients. We discuss all about surgical management of left colon cancer, including key procedures and considerations.  Surgical Approaches Several surgical approaches can be employed for the management of left colon cancer, with the choice depending on factors such as tumor size, location, and the patient’s overall health. The most common surgical procedures include: Left Hemicolectomy: This procedure involves the removal of the affected part of the left colon, along with the associated lymph nodes. The remaining healthy colon is then reconnected (anastomosed) to ensure the continuity of the digestive tract. Sigmoid Colectomy: Sigmoid colectomy focuses on the removal of the sigmoid colon, which is the S-shaped portion of the colon located just above the rectum. Similar to left hemicolectomy, it may involve reconnection of the remaining colon. High Anterior Resection (HAR): HAR is a more extensive procedure that removes not only the sigmoid colon but also a portion of the upper rectum. This procedure is often necessary when the tumor is closer to the rectum. Colostomy: In some cases, when it is not possible to re-establish continuity in the colon due to factors like tumor location or patient health, a colostomy may be performed. During this procedure, the colon is diverted to an opening in the abdominal wall (stoma), and a colostomy bag collects waste. A Few Important Facts Preoperative Assessment: A thorough evaluation of the patient’s overall health is essential before surgery. This includes assessing cardiac and pulmonary function, nutritional status, and any comorbidities that may affect the surgery’s outcome.  Bowel Preparation: Patients may be required to undergo bowel preparation before surgery, which involves cleaning out the colon to reduce the risk of infection.  Laparoscopic and Robotic Surgery: Minimally invasive approaches, such as laparoscopic and robotic-assisted surgery, have become increasingly popular for left colon cancer. These techniques offer smaller incisions, reduced postoperative pain, quicker recovery, and shorter hospital stays compared to traditional open surgery. Lymph Node Dissection: Adequate removal of regional lymph nodes is crucial for staging and to prevent cancer recurrence. Surgeons meticulously dissect lymph nodes in the affected area during the procedure. Stoma Care: For patients who undergo colostomy, education on stoma care is essential. This includes learning how to change the colostomy bag and manage potential complications. Postoperative Recovery: The recovery process after surgery typically involves pain management, dietary adjustments, and early ambulation to prevent complications like blood clots and pneumonia. Outcomes And Prognosis The prognosis for left colon cancer largely depends on factors such as the stage at diagnosis, tumor size, and the success of surgical intervention. Early-stage cancers that are completely removed through surgery often lead to excellent long-term outcomes. However, advanced-stage cancers may require additional treatments such as chemotherapy or radiation therapy. Conclusion Surgery remains a cornerstone in the management of left colon cancer. With advancements in surgical techniques, increased utilization of minimally invasive approaches, and a focus on personalized care, patients diagnosed with left colon cancer can look forward to improved survival rates and a better quality of life. Close collaboration between surgeons, oncologists, and other healthcare professionals is vital in ensuring optimal outcomes for individuals facing this challenging condition. Also Read: Robotic assisted Right Hemicolectomy – Advancements in Minimally Invasive Surgery for Colon Cancer Surgical Option for Right Colon Cancer – Right Hemicolectomy Understanding Right Colon Cancer: Symptoms, Diagnosis, and Treatment Options

Surgery for colon cancer
Colon Cancer Surgery, Colon. Cancer, Colorectal Cancer

Surgery for colon cancer: Best option for you

Surgical treatment is the most usual treatment for colon cancer and also might range from minimally invasive, such as excising a polyp throughout a colonoscopy, to, in rare instances, getting rid of the whole colon. Many surgeries for colon and rectal cancer  involve getting rid of cancer, the section of the colon in which the cancer was found, surrounding normal tissue as well as close-by lymph nodes. This is the basic principle used for all cancer surgeries of colon and rectum irrespective of whether open or minimally invasive surgical procedure is used. People may get chemotherapy treatment and/or radiation treatment before and/or after surgical procedure for rectal cancer. These adjuvant therapies may help diminish tumours prior to they are surgically gotten rid of and are intended to target cancer cells that may continue to be after surgical treatment. Such a choice will depend on the clinical staging of the cancer Local excision and polypectomy If colon or rectal polyp or cancer is found at an early stage, it can be removed, with a colonoscope. It is a excision that does not need puncturing the abdominal wall. If the excision includes the removal of a polyp, the treatment is called a polypectomy. This is also used to remove pre malignant lesions and thus need for surgery is avoided. During these procedures, a physician accesses the colon or rectum with a colonoscope as well as a connected cutting tools used to remove the polyps or unusual cells. If a polyp or location of uncommon cells cannot be excised through these treatments, laparoscopic or open surgery may be needed. Colectomy: Total or Hemicolectomy A colectomy is the removal of all or part of the colon. The resection might be carried out as a less intrusive laparoscopic colectomy. If open surgery is needed, a lengthy incision in the abdomen might be required. With open surgery, patients will remain in the hospital for a week or more and might have a longer period of recovery. Early discharge is possible with laparoscopic or open surgery. Laparoscopic surgery for Colon Cancer Colorectal surgeon will carry out a laparoscopic colectomy to get rid of the malignant part of the colon and also neighbouring lymph nodes, and afterwards reattach the healthy ends of the colon. A laparoscopic colectomy may result in less pain, a shorter stay in the health centre and also a speedier recovery. With a laparoscopic colectomy, about 4 to 5 tiny lacerations are made around the abdomen. The medical oncologist after that inserts a laparoscope, a thin tube outfitted with a small video camera that projects photos of the within the abdominal area on a nearby screen. The colorectal surgeon after that inserts tools via these small cuts to do the surgery. Types of Colectomy used for Colon Cancer The type will depend upon the location and extent of the tumour. This will also depend on the number of tumours found in the colon. Based on above these could be: Total Colectomy Subtotal Colectomy Right Hemicolectomy Right Extended Hemicolectomy Left Hemicolectomy High Anterior Resection Sigmoid Colectomy Proctocolectomy Colostomy for colon cancer A colostomy may be needed, relying on the kind as well as degree of the colon surgical treatment carried out. During this procedure, the colon is linked to a hole in the abdomen (called a stoma) to draw away faeces from a damaged or surgically fixed part of the colon or anus. Some colostomies may be reversed as soon as the repaired tissue heals. Various other colostomies are irreversible, as well as the stoma is affixed to a colostomy bag that accumulates waste. These are called permanent colostomies and are used for very low rectal cancer which is near the anus and the sphincters are involved. Proctectomy A proctectomy is used to get rid of all or part of the rectum. A low-anterior resection entails the removal of rectum for cancer located in the top part of the rectum, which is closest to the S-shaped sigmoid colon. Some surrounding healthy rectal tissue may likewise be eliminated, in addition to nearby lymph nodes and also fatty tissue. This surgery involves a joint made with special staplers and the colostomy used is temporary. A pathologist will analyse the lymph nodes to identify if cancer cells are present. This will certainly aid physicians identify the stage of the disease and also whether chemotherapy and or radiotherapy is required. After the cancerous section of the rectum is eliminated, the colorectal oncologist links the sigmoid colon with the remaining healthy part of the rectum below the cancer. This allows waste to pass typically out of the body through the anus, once the temporary stoma is removed. Abdominoperineal resection (APR) is made use of to deal with cancer in the lower rectum. Since this treatment needs removal of the cancerous section of the lower anus nearest the anus, some or every one of the anal sphincter is likewise gotten rid of. The sphincter is a muscle that maintains the anus shut and protects against stool leak. Since the sphincter is in charge of digestive tract control, the colorectal surgeon additionally carries out a colostomy to enable the body to secrete waste. Laparoscopic or Robotic Surgery for rectal cancers All kind of proctectomies in including APR are also done by these procedures. Robotic surgery gives an edge over laparoscopic surgery as it has better magnification and is more precise in limited spaces. However open surgery may be required for larger or fixed tumours of the rectum. HIPEC for Colon Cancer Hyperthermic intraperitoneal radiation treatment (HIPEC) is an extremely focused, warmed chemotherapy therapy that is supplied directly to the abdominal area throughout surgery. Unlike systemic radiation treatment distribution, which distributes throughout the body, HIPEC may supply chemotherapy directly to cancer cells in the abdomen. This allows for higher dosages of chemotherapy therapy. HIPEC might be especially practical for people with colon cancer or rectal tumours that have not involved organs such as the liver or lungs, or to lymph nodes outside the

Stage 4 Colon Cancer: Now There is Hope with Treatment
Colon. Cancer, Colorectal Cancer

Stage 4 Colon Cancer: Now There is Hope with Treatment

Colon cancer is the 3rd most commonly identified cancer in both males as well as females in the world. In India, 4.4 people per lac get colon cancer and thus almost 60,000 people get colon cancer each year or 157 new colon cancers are diagnosed every day. Overall 5 years survival rates are 14 to 19%; however 5 year survival rates for patients with stage 4 colon cancer that metastasize to liver and had removal of liver metastases at the same time as colon surgery improved up to 70%, which is a huge survival advantage. Stage 4 colon cancer is late-stage cancer in which the disease has actually spread to other tissues or body organs in the body and also is, as a result, harder to treat. Treatment may just be partly successful, and also cancer may be more likely to return after treatment. Colon cancer usually infects the liver, however it can also infect other locations like the lungs, brain, peritoneum, or to distant lymph nodes. Surgery followed by chemotherapy for stage 4 colon cancer If there are only a couple of small locations of cancer spread (metastases) in the liver or lungs and they can be removed along with the colon cancer, surgery will give the best results. Colon surgery along with removal of a part of the liver or lung containing the cancer  procedure may give better results and helps one live longer. Surgery will be followed by appropriate chemotherapy. It’s very crucial to understand the goal of the surgery ─ whether it’s to try to heal the cancer or to avoid or alleviate signs and symptoms of the cancer. This aspect has to be clearly understood, if one has stage 4 colon cancer. Chemotherapy for stage 4 colon cancer followed by surgery and further chemotherapy If the metastases cannot be eliminated because they’re too big or there are as well several of them, chemotherapy may be given before surgery (neoadjuvant chemo). Chemo may be offered once more after surgical treatment. A lot of patients respond very well to this combination management plan. At times, the secondary tumours will disappear outright and thus the surgical procedure does become simpler and yields better results. Chemotherapy for colon cancer If the cancer spread excessive and widespread, one will not attempt to treat it with surgical procedure; chemotherapy is the main therapy in these situations. Surgical procedure might still be required if the cancer  is blocking the colon or is most likely to do so; this is called colon obstruction or large intestinal obstruction. Chemotherapy remains the backbone of management in these situations. Stage 4 colon cancer with intestinal obstruction Sometimes, a surgical procedure can be avoided by putting a stent (a hollow steel tube) right into the colon where the cancer is, during a colonoscopy, to keep it open. Otherwise, operations such as a colectomy or diverting colostomy (cutting the colon above the level of the cancer, bringing it out and affixing the end to an opening in the skin on the  belly to enable waste to be collected in a bag). This is called a colostomy or an ileostomy; these are also called diversion stomas. Chemotherapy or targeted therapy or both for stage 4 colon cancer Most people with phase IV cancer cells will certainly obtain chemo and/or targeted therapies to regulate the cancer cells. A few of the most typically regimens include: FOLFOX: leucovorin, 5-FU, and also oxaliplatin. FOLFIRI: leucovorin, 5-FU, as well as irinotecan. CAPEOX or CAPOX: capecitabine (Xeloda) and oxaliplatin. FOLFOXIRI: leucovorin, 5-FU, oxaliplatin, and irinotecan. One of the above mixes plus either a drug that targets VEGF, (bevacizumab [Avastin], ziv-aflibercept, or ramucirumab, or a drug that targets EGFR (cetuximab [Erbitux] or panitumumab. 5-FU and leucovorin, with or without a targeted medication. Capecitabine, with or without a targeted medicine. Irinotecan, with or without a targeted medicine. Cetuximab alone. Panitumumab alone. Regorafenib  alone. The option of regimen to be used depends upon a number of aspects, including previous therapies you’ve had and also your overall wellness. At times one has to toggle these combinations depending upon the effectiveness of these medications. Radiotherapy for stage 4 colon cancer Radiation treatment can also be made use of to relieve signs and symptoms in the colon from the cancer such as pain. It could additionally be used to treat locations of spread such as in the lungs or bone. It may reduce tumours for a while, but it’s not most likely to treat the cancer. Outcomes after treatment of stage 4 colon cancer Thus, we can safely say that the 5 year survival rates for colon cancer range between 14% to up to 70%. The success of specific treatment approaches may differ among individuals, with treatments successful for some individuals having little effect in others. Additionally, specialists base these statistics on previous cases. As treatments often tend to get better gradually, survival rates may be more reliable and better as improved treatments become available. Specific factors can likewise play a significant function in a person’s outcome. For instance, the age as well as general wellness of a person might influence their responsiveness to therapy. Recap for Stage 4 Colon Cancer

Second Cancer After Colon Cancer: Survivors need to be careful
Colon. Cancer, Colorectal Cancer

Second Cancer After Colon Cancer: Survivors need to be careful

Colon cancer survivors can have a number of unrelated illnesses, yet usually a major concern is encountering cancer once again. Cancer that returns after therapy is called a recurrence. Some colon cancer survivors get a new unrelated cancer later in life. This is called a second cancer and has to be treated according to its own merit. They could be at greater risk for certain other types of cancer. Individuals that have had colon cancer can get any sort of second cancer , but they have an enhanced risk of the following cancers as observed: A new colon cancer which is different from the first cancer coming back Rectal cancer Uterine cancer Anal cancer Oral cavity cancer Stomach cancer Small intestine cancer Kidney cancer Bile duct cancer Reason for second cancer after Colon Cancer The increased threat with a few of these cancers might be due to common threat aspects, such as diet, obesity, as well as exercise. Genes may likewise be an element. People with Lynch disorder (genetic non-polyposis intestines cancer cells) have actually an increased risk of many of these cancers. Follow-up after colon cancer surgery After finishing therapy for colon cancer, you should still see your physician regularly to try to find indications that cancer has actually returned or spread out. Survivors of colon cancer must additionally comply with the Screening Guidelines for the Early Detection of Cancer, such as those for breast, cervical, lung, as well as prostate cancer. For individuals who have actually had colon cancer , most experts don’t advise any extra screening to try to find second cancers unless one has symptoms. One possible exemption is in women that had colon cancer as a result of having Lynch disorder, as these women are likewise at raised threat for endometrial and also some other cancers. If you have Lynch disorder or one or more acquired syndrome, it’s important to talk to your doctor regarding your dangers. Can I decrease my danger of getting a second cancer? There are actions you can take to reduce your risk and stay as healthy and eat balanced diet as feasible. For example, people who have had intestines cancer cells ought to do their finest to stay away from tobacco items. Smoking cigarettes may even more enhance the risk of a few of the second cancers that are extra common after intestines cancer. To aid keep good wellness, colon cancer survivors need to: Get to and remain at a healthy and balanced weight. Be energetic Follow a healthy eating pattern that consists of plenty of fruits, vegetables, and whole grains, and restrictions or stays clear of red and processed meats, sweet drinks, as well as processed foods. It’s best not to drink alcohol. If you do drink, have no more than 1 beverage each day for ladies or 2 per day for men. Dr. Rajeev Kapoor is the best colon cancer surgeon in Chandigarh. If you diagnosed with colon cancer, make an appointment today!

Survivor Story: Colon Cancer Surgery – During and After
Cancer, Colon Cancer Surgery, Colon. Cancer, Colorectal Cancer, Colorectal Surgery, Survivor story

Survivor Story: Colon Cancer Surgery – During and After

This is a story of one of my patient about her fight with colon cancer. She wanted to write and I encouraged her to put her experience in words. She did so, but decided that she wanted her name be changed. It all began in 2016. Sonia, a 46-year-old, mom of a then 20 year old was working full time awakened with what she assumed was a stomach ache that just didn’t want to disappear. Throughout the day it seemed to get worse and by that night she could not walk. Her husband was away on a business trip and thus her daughter, who was in Delhi university returned and took her to the hospital. Also See: Colon Cancer Surgeon in Chandigarh Diagnosis of colon cancer Lot of tests were done and the CAT Scan found a mass in her right colon which looked like a tumour. She remained in the hospital for seven days. As she writes, “Ten days of worry, testing, scans, surgical treatment and also a lot of bonding with the nurses”. During that time, a colonoscopy confirmed that the tumour had actually shut off her colon, a Pet scan validated that it had grown past the colon walls and also into the lymph nodes. So she had what we call cancer of the right colon. Once a cancer is diagnosed with colonoscopy and biopsy, the PET CT assesses the entire body for any spread. After these tests, we stage the tumour by giving it a number. Thus Sonia had stage 3 of right sided cancer of the colon and required urgent colon cancer surgery as the lesion was obstructing her ascending colon. This is called a obstructing colon cancer is normal parlance. Colon Cancer Surgery Laparoscopic surgical treatment removed the tumour, 24 cm of colon and also 21 lymph nodes. She recovered well to go home and to be followed up in the OPD. Her case was discussed in hospital tumour board and her cancer was labelled as a Stage III Colon Cancer. Her final biopsy had shown some small vessel infiltration. She was referred to medical oncologist, who made a decision that even though the nodes weren’t impacted, it would be only a short time prior to they would certainly have been, so they decided to give her chemotherapy. This is what Sonia says “Up until this point, I had been living with an extremely worn out sensation at all times as well as taking medication for chest allergy due to the fact that I was having a difficult time capturing my breath. However it turned out I was extremely anaemic and B-12 deficient. My haemoglobin was so low. After the surgery, I felt better as I had received blood transfusions. My pain was gone and since there was no big incision for my surgery, I started feeling good and cheerful” Colon cancer chemotherapy Chemotherapy treatment started a month later and consisted of 5FU, Leucovorin and Oxalliplatin. She writes “life was far from typical. I needed to take added iron tablets as well as have B-12 shots. I got on 3 types of anti-nausea drug. My hair fell from the chemo, I had consistent nose and anal bleeds but had the ability to maintain my composure as well as a will to survive.” So all patients of stage 3 and 4 with colon cancer receive chemotherapy after colon cancer surgery. Some patients of stage 2 also receive chemotherapy after colon cancer surgery as they have some bad prognostic markers. Sonia had obstruction as well as some small vessel infiltration with tumour and thus was earmarked for chemotherapy. The chemotherapy is started about 4 weeks after the surgery and the wounds are completely healed. In the interim a port is inserted to deliver chemotherapy. Sonia writes “I still had fatigue however, I had to will myself to try as well as live a rather regular life. Strolling was difficult as a result of the wooziness. I fell a number of times due to the enduring neuropathy in my feet. I had several issues with my power port but in the end everything worked well. Throughout this experience I utilized the expression “It’s all excellent” as my reply when asked just how I was doing.” Also See Rectal Cancer Surgeon in Chandigarh Colon cancer surveillance Sonia will be followed up every 3 months for five years, with proceeded checks up to 10 years. Sonia has persuaded her friends to go for screening and all have lately been checked out by their doctors. Colon cancer presents in many ways. Sonia had a complicated presentation as she developed intestinal obstruction because of colon cancer. Colon cancer surgery remains the mainstay of treatment. Laparoscopic surgery is the preferred method to do surgery. The surgeries include right, extended right or left hemicolectomy. Chemotherapy is given after surgery for some stage 2, stage 3 and stage 4 colon cancers. Preoperative chemotherapy may be used in stage 4 cancers before surgery is planned. Survival is very good in colon cancer and one should not give up hope. Sonia’s story should be a great motivator for all patients with colon cancer.

Colon Cancer: Presentation, Diagnosis and Treatment
Colon. Cancer, Colorectal Cancer

Colon Cancer: Presentation, Diagnosis and Treatment

Colon cancer is a type of cancer that begins in the big intestine (colon). The colon is the last part of the digestion tract starting at cecum on right side and ending at rectum and anal canal. Colon cancer commonly impacts older adults, though it can happen at any kind of age. It usually starts as a tiny polyps that form on the inside of the colon and grows larger. Polyps are benign. Gradually these polyps can become colon cancers. Colon cancer is often called colorectal cancer, which is a term that integrates colon cancer and rectal cancer, which begins in the rectum. Large Intestine Polyps might be tiny as well as multiple, if any type of, signs. For this reason, doctors advise regular screening tests to aid protect against colon cancer cells by identifying as well as getting rid of polyps before they develop into cancer. If colon cancer develops, lots of therapies are readily available to help get rid of it, consisting of surgical treatment, chemotherapy treatment as well as medicine treatments, such as radiation treatment, targeted therapy and immunotherapy. What are the Signs and Symptoms of colon cancer A persistent modification in your bowel practices, consisting of diarrhoea or irregularity or a change in the consistency of your faecesAnal bleeding or blood in your faecesPersistent abdominal painA sensation that your bowel doesn’t empty totallyWeakness or exhaustionInexplicable weight reduction Many individuals with colon cancer experience no symptoms in the beginning of the illness. When symptoms show up, they’ll likely differ, relying on the cancer cells’ size and also location in your large intestinal tract. When to see a medical professional If you see any one of the above symptoms or signs that stress you, make an appointment with your medical professional. How does colon cancer starts Physicians aren’t certain what creates most colon cancers. However, generally, colon cancer begins when healthy and balanced cells in the colon develop modifications (anomalies) in their DNA. A cell’s DNA includes a collection of directions that inform a cell what to do. When a cell’s DNA is harmed and also ends up being cancerous, cells proceed to split– also when brand-new cells aren’t needed. As the cells accumulate, they create a growth. With time, the cancer cells can expand to invade as well as damage typical organs nearby. As well as malignant cells can travel to other parts of the body to develop deposits there (spread). What are the causes or risk factors of colon cancer? Older age. African-American race. A personal history of colon cancer or polyps. Family history of colon cancer Inflammatory digestive tract conditions. Inherited syndromes like familial adenomatous polyposis (FAP) and also Lynch disorder, which is likewise known as hereditary nonpolyposis intestines cancer cells (HNPCC). Low-fiber, high-fat diet. An inactive way of life. Obesity. Diabetes mellitus. Smoking cigarettes. Heavy use of Alcohol. How do we diagnose colon cancer? • Colonoscopy: It uses a long, versatile and also slender tube affixed to a camera and screen to see your whole colon as well as anus. If any questionable areas are discovered, your medical professional can pass medical tools via television to take tissue examples (biopsies) for evaluation and get rid of polyps.• Blood examinations• CEA levels: Tracked gradually, the degree of CEA in your blood may help your medical professional comprehend your prognosis and also whether your cancer is responding to therapy.• CT Scan• PET Scan What is Staging of Colon Cancer? Staging helps establish what therapies are most appropriate for you. The stages of colon cancer are shown by Roman numerals that vary from 0 to IV, with the most curable stages being I to III suggesting cancer that is limited to the lining of the within the colon. By stage IV, the cancer cells has actually spread (metastasized) to other locations of the body and the cure becomes limited. How do we treat Colon Cancer? Treatment depends on the staging of the colon cancer. Type of surgery depends on the location of the colon cancer. Modality of surgery depends on the expertise of the surgeon as well as the stage and extent of the tumour. Therapy for colon cancer generally entails surgical treatment to get rid of the cancer. Various other therapies, such as radiation treatment and chemotherapy, may likewise be advised as required according to the final stage. Surgery for very early-stage colon cancer like polyps If your colon cancer is extremely tiny, your medical professional might advise a minimally invasive method to surgical procedure, such as:• Polypectomy: If your cancer is small, localized, entirely included within a polyp and in a really beginning, your medical professional may be able to remove it totally with colonoscopy.• Endoscopic mucosal resection: Larger polyps might be eliminated during colonoscopy making use of unique devices to remove the polyp and a percentage of the internal lining of the colon in a treatment called an endoscopic mucosal resection. If it is a limited growth in the colon then the options available are: Keyhole surgical procedure (laparoscopic surgical procedure): In this treatment, your doctor does the operation via a number of tiny cuts in your stomach wall, placing instruments with affixed electronic cameras that display your colon on a video clip display. The specialist might likewise take samples from lymph nodes in the location where the cancer is located. Open Surgery: The surgery is done by the open method in which a large incision is used. If the tumour is badly stuck all around or it is very large or invading surrounding structures, then this traditional method is used. The decision depends on the operating colorectal surgeon. Partial colectomy: Throughout this treatment, the surgeon eliminates the part of your colon which contains the cancer, in addition to a margin of regular colon on either side of the cancer cells Your surgeon is often able to reconnect the ends of your colon or rectum. This treatment can frequently be done by a minimally invasive technique (laparoscopy or robotic surgery). Its called right

Scroll to Top