Dr. Solon Gonçalves Souza Menezes
Professor of Surgery — FAMED UFU · Board certification in Digestive System Surgery (CBCD/AMB) · Robotic Surgery certification (Intuitive / Albert Einstein Hospital) · Practices at UMC and Mater Dei Santa Genoveva Hospitals, Uberlândia-MG · (34) 99341-0915
Colon cancer is a malignant neoplasm that originates in the mucosa of the large intestine, most often through the progressive transformation of adenomatous polyps over several years. It is one of the most common tumors of the digestive tract in Brazil, affecting men and women generally after age 50, although cases in younger patients have been diagnosed with increasing frequency. In its early stages, it is usually asymptomatic, which reinforces the importance of screening by colonoscopy. When present, warning signs include blood in the stool or occult blood, a persistent change in bowel habits (diarrhea or constipation), abdominal pain or distention, iron-deficiency anemia without an apparent cause, unintentional weight loss, and fatigue. These symptoms, whether isolated or combined, warrant medical evaluation and endoscopic investigation, particularly in patients with a family history of colorectal cancer or intestinal polyps.
The diagnosis of colon cancer is confirmed by colonoscopy with biopsy of the lesion, complemented by staging exams such as computed tomography of the abdomen, pelvis, and chest, measurement of the CEA tumor marker, and, in selected cases, magnetic resonance imaging. Once the disease stage is defined, surgery — colectomy, with removal of the affected segment and regional lymphadenectomy — constitutes the basis of potentially curative treatment in most cases, allowing both removal of the tumor and histopathological analysis of the lymph nodes, which is essential for determining whether adjuvant chemotherapy is indicated. Surgical and oncological planning is conducted by Dr. Solon Gonçalves (CRM-MG 79366), a surgeon board-certified in Digestive System Surgery by the Brazilian College of Digestive Surgery (Colégio Brasileiro de Cirurgia Digestiva, CBCD), a society affiliated with the Brazilian Medical Association (Associação Médica Brasileira, AMB), with a practice focused on oncological surgery of the digestive tract. Each case is evaluated individually, taking into account tumor location, stage, the patient's clinical condition, and response to any associated therapies, in order to define the most appropriate strategy.
Colectomy is indicated according to tumor location: right colectomy (or extended right colectomy) for lesions in the cecum and ascending colon, left colectomy for the descending colon, and sigmoidectomy for tumors in the sigmoid colon, always accompanied by regional lymphadenectomy for adequate staging. In elective cases, the laparoscopic and robotic approaches are generally preferred because they allow for less surgical trauma, while the open approach (laparotomy) remains indicated in urgent situations, bulky tumors, or extensive adhesions. After resection, intestinal continuity is usually restored by primary anastomosis, although a temporary or permanent colostomy may be necessary depending on the clinical situation. In locally advanced or metastatic tumors, adjuvant chemotherapy — and, in specific situations, neoadjuvant chemotherapy — may be combined with surgery, always defined jointly with the clinical oncology team.
What to expect before and after surgery.
Preoperative preparation
Preoperative preparation for oncologic colectomy typically includes a complete clinical and anesthetic evaluation, staging exams, and optimization of any comorbidities before admission. It may also involve bowel preparation, temporary adjustment of current medications, and specific fasting instructions, according to the care team's protocol. The exact steps and time required generally vary according to the patient's overall condition, tumor location, and the planned surgical approach, and should always be defined individually.
Recovery and postoperative care
Recovery after oncologic colectomy generally involves a gradual return to diet, early ambulation, and pain control according to the team's protocol, which may vary depending on the surgical approach used and each patient's clinical progress. Length of hospital stay and return to normal activities tend to depend on individual progress and any complications, and are always assessed on a case-by-case basis. Follow-up outpatient care usually includes review of the pathology report and, when indicated, discussion of the need for additional treatment.
Common questions about this procedure.
What symptoms of colon cancer should be investigated?+
Blood in the stool or a positive occult blood test, a persistent change in bowel habits, abdominal pain or distention, anemia without an apparent cause, and unintentional weight loss are warning signs. Many early-stage cases are asymptomatic, which is why screening colonoscopy starting at age 45 to 50, or earlier in those with a family history, is an effective way to identify the disease at an early stage.
Which exams confirm the diagnosis of colon cancer?+
The diagnosis is confirmed by colonoscopy with biopsy of the lesion. Staging is complemented by computed tomography of the abdomen, pelvis, and chest, measurement of the CEA marker, and, in selected situations, abdominal magnetic resonance imaging or PET-CT, depending on tumor location and the need for better characterization of suspicious lesions. These exams guide surgical planning and the definition of associated therapies.
How long does colectomy surgery take and what type of anesthesia is used?+
Colectomy usually takes between two and four hours, varying according to the surgical approach, tumor location, and case complexity. It is performed under general anesthesia, with an individualized preoperative anesthesia evaluation. This time may be longer in more complex surgeries or when associated resections are needed.
How many days of hospitalization are needed after colectomy?+
Hospital stay after colectomy generally ranges from three to seven days, and may be shorter after minimally invasive surgery with a favorable recovery, or longer in more complex cases or if complications arise. The exact length of stay depends on each patient's clinical course and should be discussed individually with the care team.
Does colectomy cause significant postoperative pain?+
There is postoperative pain, controlled with multimodal analgesia prescribed according to protocol, generally more intense in the first 48 hours and decreasing progressively. Laparoscopic or robotic surgery tends to involve less pain and faster recovery of mobility compared to the open approach, although individual pain response varies.
Is a drain, catheter, or colostomy needed after colectomy?+
The use of an abdominal drain and a urinary catheter is common in the first few days and is removed as recovery progresses. A colostomy or ileostomy is not necessary in most elective colectomies with primary anastomosis, but may be indicated temporarily or, in specific cases, permanently, depending on tumor location and the surgical conditions encountered.
What do colectomy scars look like?+
With the laparoscopic or robotic approach, the scars are usually small incisions (a few centimeters) plus one slightly larger incision for removal of the surgical specimen. With the open approach, there is a single, more extensive scar, usually along the midline of the abdomen. The final appearance varies according to individual healing and any complications.
How long is the patient away from work after surgery?+
Time away from work usually ranges from four to six weeks for regular activities, and may be shorter after minimally invasive surgery without complications, or longer for jobs involving intense physical exertion or when adjuvant chemotherapy is needed. The return to work is always determined individually by the medical team.
What are the main risks, complications, and contraindications of colectomy?+
As with any major abdominal surgery, colectomy carries risks such as bleeding, surgical site infection, anastomotic dehiscence, incisional hernia formation, and anesthetic or thromboembolic complications. Severe, uncontrolled comorbidities may temporarily contraindicate the procedure until clinical stabilization is achieved. Each risk is assessed according to the patient's individual profile before surgery is indicated.
Is chemotherapy or radiotherapy always required after colectomy?+
No. The indication for adjuvant chemotherapy depends on the pathological stage determined after surgery, particularly lymph node involvement. Radiotherapy is more relevant for rectal tumors than for colon tumors. The decision is made by a multidisciplinary team — oncological surgeon, clinical oncologist, and, when indicated, radiation oncologist — individualized for each patient.
Hospital facilities in Uberlândia, Brazil.
Hospital Mater Dei Santa Genoveva
Av. Vasconcelos Costa, 967 — Martins, Uberlândia-MG
Open in Google Maps →Content reviewed by Dr. Solon Gonçalves Souza Menezes — CRM-MG 79366, RQE 60355 (GI Surgery), RQE 44656 (General Surgery). Professor of Surgery at FAMED-UFU and Supervisor of the General Surgery Medical Residency Program at HC-UFU. ORCID. Last reviewed: September/2026.
- US Preventive Services Task Force. Screening for Colorectal Cancer: US Preventive Services Task Force Recommendation Statement. JAMA. 2021;325(19):1965-1977. doi:10.1001/jama.2021.6238
- Emile SH, Horesh N, Garoufalia Z, et al. Robotic and laparoscopic colectomy: propensity score-matched outcomes from a national cancer database. Br J Surg. 2023;110(6):717-726. doi:10.1093/bjs/znad096
- de Almeida Leite RM, Araujo SEA, Callado GY, Bossie H, Ricciardi R. Oncologic outcomes for robotic versus laparoscopic colectomy for colon cancer: an ACS-NSQIP analysis. J Robot Surg. 2024;18(1):341. doi:10.1007/s11701-024-02097-0
- Pericay C, Montagut C, Reina JJ, et al. SEOM-GEMCAD-TTD clinical guidelines for the adjuvant treatment of colon cancer (2023). Clin Transl Oncol. 2024;26(11):2812-2825. doi:10.1007/s12094-024-03559-5