5.

Surgical treatment

Clinical stage	Stratification	Class I recommendation	Class II recommendation	Class III recommendation
a, Radical surgery involves colon resection and regional lymph node dissection. Root lymph nodes at the origin of feeding vessels or suspected lymph nodes outside the dissection area should be removed or biopsied. Only complete resection surgeries can be considered radical surgeries. b, Surgery options include one-stage resection and anastomosis; one-stage resection and anastomosis + proximal protective stoma; one-stage tumor resection, proximal stoma, and distal closure; or two-stage resection after ostomy. Laparoscopic surgery is not recommended. c, Intestinal stents are usually applicable for lesions at the distal colon as it can result in decompression of the proximal colon, thereby allowing one-stage anastomosis in elective colectomy (11). d, Selected according to the degree of peritoneal contamination. Surgical methods similar to b, with sufficient flushing and drainage.
cT1−4, N0−2M0 stage I−III	Symptoms that do not require emergency treatment	Coloctomy with enbloc removal of regional lymph nodesa	—	—
cT1−4, N0−2M0 stage I−III, symptoms requiring emergency treatment	Obstruction	Operationb	Stent, two-stage radical resectionc	—
	Perforation	Operationd	—	—
	Hemorrhage	Coloctomy ± enbloc removal of regional lymph nodes	Endoscopic interventional embolization, selective operation	—