Oncological radicality in colonic cancer operation

Lymphadectomy should extend to the level of the origin of the primary feeding vessel, suspected positive lymph nodes outside the standart resection should be removed when feasible. A minimum 5 cm bowel margins proximally and distally should be used and peroperative histology must confermend tumor free anastomosis. En-block resection should be performed for tumors adherent to local structures. Inadvertent bowel perforation increases the risk of recurrence and should be avoided. Ovaries grossly involved with tumor should be removed. In all women having operations for cancer of the colon bilateral oophorectomy should be performed. In premenopausal women the ovary is a frequent site for metastatic disease (the Krukenberg tumor) which occures as often as 25 percent of the time. The incidence of of ovarian metastasis is much lower in postmenopausal women but the consequences of oophorectomy are also less severe in that age group. (Ref. 9.).