**4. Therapeutic principles**

#### **4.1 Large bowel obstruction**

Large bowel obstruction – is the most common complication of colorectal/rectal colon and transverse colon, representing about 77% of the entire volume of complications [27, 28]. The most common symptom is the lack of bowel movement in a patient with intestinal transit disorders. Due to the relatively large diameter of the proximal colon, ascending and transverse, the tumors become palpable, giant even, a long time before producing mechanical occlusion [29].

In this situation, the technical principle is segmental resection (**Figure 1**) represented by the right hemicolectomy, detailed by Kohler and Mikulicz or extended to the right, towards the left of the middle colic vessels followed by an ileocolic anastomosis or the segmental resection (transversectomy) followed by end-to-end anastomosis. There are divergent views and, in this regard, many articles and studies show that limited resections, such as transversectomy are more effective [24, 30].

If the location of the tumor is at the level of the hepatic flexure, then the common surgical procedure is a standard right hemicolectomy, with right omentectomy and
