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Source created 2026-08-24 · updated 2026-08-24
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ASCRS Ch25 — Colon Cancer Surgical Treatment: Principles of Colectomy

Citation: Carchman EH, Kalady MF. "Colon Cancer Surgical Treatment: Principles of Colectomy." In: Steele SR, et al. (eds.), The ASCRS Textbook of Colon and Rectal Surgery, 4th ed. Springer Nature Switzerland AG; 2022. pp. 451–462 (PDF pp. 455–466 of the combined textbook file). Source file: raw/ASCRS Textbook 4th Ed.pdf (full 1,198-page textbook; cite by page range within the single PDF). Sixth chapter of Part III ("Malignant Disease").

Type: Specialty textbook chapter (reference/background, not primary literature).

Scope

Twenty-fifth chapter of the sequential full-textbook ingest (see ASCRS Ch01 - Anatomy and Embryology for the ingest's scope/plan). Covers preoperative tumor localization (mislocalization rates, endoscopic tattooing/clip technique), general surgical principles (margins, no-touch technique, lymphadenectomy, complete mesocolic excision/central vascular ligation, adjacent organ invasion), surgical procedures by anatomic tumor location (cecum/ascending colon, hepatic flexure, transverse colon, splenic flexure/descending colon, sigmoid colon), special circumstances (obstructing/perforated colon cancer, Lynch-syndrome-associated colon cancer), and neoadjuvant systemic/chemoradiotherapy for locally advanced colon cancer.

Key content

This chapter substantially overlaps the already-ingested Colon Cancer Resection procedure page (sourced from an earlier Sabiston chapter, covering the same right/transverse/splenic-flexure/left technique-by-location framework) — per the wiki's reconciliation practice, this chapter's content was folded into that existing page as enrichment rather than duplicated. Notably, it resolves Colon Cancer Resection's own previously-flagged open item asking whether complete mesocolic excision (CME) appears elsewhere in the textbook — it does, in detail, here. It also substantially overlaps Obstructing Colon Cancer (obstructing/perforated colon cancer management) and Lynch Syndrome (surgical resection extent in Lynch-associated colon cancer, citing the same ASCRS guideline already covered there in more depth) — both enriched with genuinely new technical detail rather than duplicated wholesale. A brief FOxTROT-trial mention on Colorectal Cancer Staging (TNM) (from Ch24) is now backed with the actual trial data (downstaging, nodal/margin improvement, regression rate) via a new neoadjuvant-therapy section on Colon Cancer Resection.

Limitations

  • Textbook chapter, not primary literature; cited data (Bertelsen CME cohort, Varty splenectomy case-control study, FOxTROT Collaborative Group data referenced as an abstract/conference report for one endpoint) are the chapter authors' synthesis, not independently re-verified.
  • CME's oncologic benefit is described via retrospective cohort data only (Bertelsen et al.); the chapter explicitly notes there are no RCTs comparing CME to standard colectomy.

Relevance

Twenty-fifth entry in the ASCRS ingest, sixth chapter of Part III ("Malignant Disease"). Mainly a reconciliation chapter — its main contribution is the CME/central-vascular-ligation technique detail Colon Cancer Resection previously lacked (closing a self-flagged gap from several chapters ago), plus tattooing/localization detail and obstructing-colon-cancer technical nuance.