Surgical treatment of cancer of the colon

The authors give a brief review of the course of surgical treatment for colon cancer in the last two decades, as reported in the medical literature. Between 1960 and 1980 they examined 619 patients. Of these, 599 underwent surgery: 436 (72.8%) had radical surgery and 163 (27.2%) received palliative operations. The morbidity was 12.1% and the mortality 2.7%. Sixty per cent of the patients in Dukes' class "A" and "B" were alive after five years, against 28% of those in class "C" and non in class "D". The results obtained during the 1970 to 1980 period are not significantly better than those obtained from 1960 to 1969. On the basis of this experience, the authors describe their present approach for the treatment of tumors of the colon and explain in detail the preoperative preparation of the patients, the extension of the excisions and of the lymphectomies, according to the site of the cancer and its local or distant invasion, the use of temporary derivative colostomies and the application of additional medical therapies. Guidelines for reaching an early diagnosis of colon carcinoma are given, in order to improve the postoperative survival rate.