Surgical principles of colectomy

These may be summarised thus;

• Avoid dissemination of the tumor

  Haematogenous

  No touch technique with ligation of the vascular pedicles before the tumor is mobilised, as popularised by Turnbull

  Trans-luminal

  Tapes proximal and distal to the tumour, wash out of bowel with tumoro-cidal agent

• Enbloc removal of tumor and draining lymph nodes; This is accomplised by ligation of the vascular pedicle as high as is safe.
• Preserve intestinal continuity where possible; This is accomplised by stoma avoidance, the use of temporary stomas and by the use of on table lavage.