Medical Oncologist
CION Cancer Clinics
Right hemicolectomy: what it removes and who needs it | CION Cancer Clinics
A right hemicolectomy removes the right side of the colon, with its blood vessels and lymph nodes, and joins the small bowel to the colon that remains. It is the standard operation for cancers of the caecum, the ascending colon and the bend under the liver. This page explains what is removed, why, what happens before the operation and how life works afterwards. At CION Cancer Clinics, a multidisciplinary team plans colon cancer treatment for your stage, from surgery to chemotherapy and follow-up.
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Medically reviewed by Dr. Muralidhar MuddusettyConsultant Surgical Oncologist · MBBS (AIIMS), MS (Surgery, AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh) · last reviewed October 2026, next review due October 2027
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On this page
- What is a right hemicolectomy, and why is it the operation for your tumour?
- Which colon tumours lead to a right hemicolectomy?
- What happens between diagnosis and a right hemicolectomy?
- The words you will meet, in plain language
- How will your bowels work without the right colon?
- What this page cannot tell you
- Common questions about right hemicolectomy
The short answer
What is a right hemicolectomy, and why is it the operation for your tumour?
A right hemicolectomy removes the right side of the large bowel, where most right-sided colon cancers start. The surgeon takes out the tumour together with its blood supply and the lymph nodes, the small glands that filter fluid from the bowel, then joins the small bowel to the remaining colon.
What is taken out
The operation removes the caecum (the pouch where the colon begins), the ascending colon that runs up the right side of the belly, and the bend under the liver called the hepatic flexure. The last short stretch of small bowel and the appendix come out with it, because they share the same blood vessels. The fatty tissue holding those vessels and nodes is removed in one piece, and that is what makes the operation a cancer operation.
Why the cut follows the blood vessels
Colon cancer spreads first along the lymph channels that travel beside the arteries. So the surgeon decides how much bowel to remove by which arteries feed the tumour, not by how large the tumour looks. That is why a small tumour in the caecum still needs a full right hemicolectomy.
The page on which operation suits which part of the colon shows the whole map.Who it is for
Which colon tumours lead to a right hemicolectomy?
The deciding question is where the tumour sits. Your colonoscopy and CT scan answer that before anyone talks about surgery.
Caecum and ascending colon
This is the standard case. Tumours here often bleed slowly into the stool without being seen, so many people first learn of them through anaemia, a low haemoglobin, and tiredness rather than visible blood.
Hepatic flexure
A tumour at the bend under the liver sits where two blood supplies meet. The surgeon may remove a longer piece of transverse colon, which is called an extended right hemicolectomy.
A polyp that could not be removed safely
Some large flat polyps on the right side cannot be lifted out through the colonoscope. Others are removed and the biopsy shows cancer with worrying features. Either way, surgery may follow.
Usually decided by
- How deep the cancer had grown
- Whether the edge of the polyp was clear
- Cancer cells seen inside small vessels
Some appendix and small bowel tumours
Certain tumours of the appendix, or at the junction of the small and large bowel, are treated with the same operation. The pathology report decides whether this is needed.
Not sure whether this applies to you?
Ask an oncologistFrom report to operation
What happens between diagnosis and a right hemicolectomy?
The tumour is located and sampled
CION arranges the colonoscopy and biopsy through a diagnostic partner. The endoscopist often marks the spot with a small ink tattoo so the surgeon can find it from outside the bowel.
Staging scans
A CT scan of the chest, abdomen and pelvis checks the liver, lungs and lymph nodes. A blood test called CEA, a protein some colon cancers release, is taken as a starting value for later comparison.
The tumour board decides
Surgeons, medical oncologists and radiologists review the scans together. They confirm the operation, whether surgery should come first, and whether you are fit for a general anaesthetic.
The operation at a partner hospital
CION's surgical oncologists plan the operation, and it is carried out at an accredited partner hospital. Most are done by keyhole surgery, and the technique and hospital stay are covered separately.
The pathology report
The removed bowel is examined under a microscope. Its findings set the final stage and decide whether you need chemotherapy after surgery.
On your consent form
The words you will meet, in plain language
- Ileum
- The last part of the small bowel. A short end piece is removed along with the right colon.
- Ileocolic anastomosis
- The join between the small bowel and the remaining colon. It is stitched or stapled so stool can pass normally.
- Mesocolon
- The fatty sheet carrying the colon's blood vessels and lymph nodes. Removing it intact is called complete mesocolic excision.
- Lymph node yield
- How many nodes the pathologist found in the specimen. Guidelines ask for at least twelve so the stage is reliable.
- Margin
- The healthy tissue around the tumour at the cut edges. A clear margin means no cancer cells reach the edge.
- MMR or MSI test
- A check on the tumour tissue for faulty repair genes. Right-sided cancers show this more often, and it can point to an inherited cause.
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Did you know
A planned right hemicolectomy rarely needs a stoma. The small bowel and colon usually heal well together, so a bag is mostly reserved for emergencies or very unwell patients. The page on whether you will need a stoma explains when one is made.
Life afterwards
How will your bowels work without the right colon?
Most people live normally without the right colon. The rest of the large bowel takes over its work of absorbing water. In the first weeks stools are often looser and more frequent, and for most people this settles gradually.
Why some people stay looser
The valve between the small and large bowel is removed, so food moves through a little faster. In a few people, bile that the small bowel normally reabsorbs reaches the colon and causes watery diarrhoea. This is treatable, so tell your team if loose stools continue.
Eating at home
Soft rice, dal, curd rice and well-cooked vegetables are usually easy in the early weeks. Spicy pickles and a sudden load of raw salad can wait. Our diet after colon cancer surgery page goes through it meal by meal.
Fever, belly pain that worsens after the first few days, or vomiting after surgery need a call to the surgical team the same day.Being straight with you
What this page cannot tell you
It cannot tell you whether a right hemicolectomy is the right operation for you. That depends on the exact tumour position on your scans, any spread, your heart and lung fitness and your other illnesses. The tumour board weighs these together, and the surgeon explains the reasoning at your consultation.
Who this does not apply to
It does not apply to tumours in the descending or sigmoid colon, which need a left or sigmoid colectomy. It does not cover cancer of the rectum, which is treated differently and has its own rectal cancer pages. People with an inherited condition such as Lynch syndrome or FAP may be offered a larger operation instead.
It cannot read your report
If you already have a pathology report, the node count, margins and vessel findings need an oncologist to interpret them in context. Bring the report and the scan discs to your appointment.
If you have been told you need this operation and want a second look at the plan, the helpline can arrange a tumour board review.Questions we are asked
Common questions about right hemicolectomy
Is a right hemicolectomy a major operation?
Yes. It is done under general anaesthetic and involves a hospital stay, usually close to a week. Most people are walking the next day. Keyhole surgery tends to mean less pain and a quicker return to eating, but it is still major bowel surgery.
Can I live a normal life without part of my colon?
Yes. The remaining colon adapts and most people return to work, normal food and travel once they have recovered. Bowel habits may stay a little looser than before. That is common and usually manageable with diet and, if needed, simple medicines.
Will I need a colostomy bag?
Usually not after a planned right hemicolectomy. A temporary stoma is sometimes made in an emergency, such as a blocked or burst bowel, or if you are very unwell. Your surgeon will tell you before the operation if one is likely.
Why remove the appendix and part of the small bowel?
They share the same blood vessels and lymph channels as the right colon. Removing the vessels and nodes properly means taking the bowel they supply. The loss of a short end of small bowel rarely causes lasting problems.
What is an anastomotic leak?
It is when the join between the bowel ends does not seal fully and bowel contents escape into the belly. It is uncommon after a right-sided join but serious. Signs include fever, worsening pain and a fast pulse. The leak page explains it fully.
Will I need chemotherapy after the operation?
That depends on the pathology report. If lymph nodes contain cancer, chemotherapy is usually advised. Some node-negative cancers with high-risk features may also benefit. The medical oncologist explains this after the report arrives, once you have recovered enough.
Does CION perform the surgery itself?
No. CION's surgical oncologists assess you and plan the operation, and it is carried out at an accredited partner hospital. Chemotherapy, follow-up and surveillance continue at your CION centre afterwards, so the same team stays with you.
Can an elderly parent have this operation?
Age alone does not rule it out. Fitness matters more: the heart, lungs, kidneys and how active the person is day to day. The team assesses this before deciding. When surgery is too risky, other approaches can be discussed with the family.
Your Specialists
Meet CION's colon cancer specialists. Bring your colonoscopy, scan or biopsy report.
Our surgical and medical oncologists plan colon cancer care together: which operation, whether chemotherapy is needed, and the follow-up that comes after.
Medical Oncologist
Dr. C. Raghavendra Reddy
MBBS(Gold Medal), DNB(General Medicine), DM(Medical Oncology)(Gold Medal)
Medical Oncologist
Dr. Bharati Devi Gorantla
MBBS, MD(General Medicine), DM(Medical Oncology)(Adyar,Chennai), ECMO, MRCP SCE(UK)
Medical Oncologist
Dr. Owais Mohammed
MBBS, MD (General Medicine), DrNB (Medical Oncology), ECMO, MRCP SCE (Medical Oncology) (UK)
Medical Oncologist
Medical Oncologist
Surgical Oncologist
Dr. Muralidhar Muddusetty
MBBS (AIIMS), MS (Surgery) (AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh)
Surgical Oncologist
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Sources
- American Cancer Society — Colon Cancer Surgery
- National Cancer Institute — Colon Cancer Treatment
- NHS — Treatment for bowel cancer
- Cancer Research UK — Treatment for bowel (colorectal) cancer
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
Keep reading
Related pages
Which operation for which part of the colonSee how tumour position decides the operationLeft hemicolectomy and sigmoid colectomyThe operation if your tumour is on the left sideComplete mesocolic excisionWhy surgeons talk about removing the fatty sheet intactWhat a colectomy involvesThe technique, hospital stay and recovery in detail
Talk to us
Have you been told you need a right hemicolectomy?
Send us your colonoscopy and scan reports and a CION surgical oncologist will go through the plan with you, including whether surgery should come first. One helpline serves every CION centre.