The incidence of colorectal cancer is increasing year by year in China, especially in economically developed regions. At present, the main factors of colorectal cancer are lifestyle, genetic factors and environmental problems. In recent years, the occurrence of colon cancer, especially right-sided colon cancer (including cecum cancer, ascending colon cancer, colon liver flexure cancer and right-sided transverse colon cancer), has increased significantly. Zhu Jianwei, Department of Gastrointestinal Surgery, Nantong University Hospital When right colon cancer is found, the tumor has been growing for a long time, and there are more advanced stages of the disease. It turns out that the diameter of the right hemicolectomy tube is relatively large and far from the anus, so it takes a long time after the tumor occurs, and it is only discovered when anemia, weakness, diarrhea and abdominal masses appear, and at that time, the tumor has often broken through the plasma membrane, and direct invasion, lymphatic and hematogenous metastasis occurs. Some patients take anemia as the first symptom, especially female patients, because of menstruation, they often do not pay attention to it, thinking that anemia may be related to menstruation, and wait until the anemia becomes more and more serious before they want to go to hospital for examination, as a result, the treatment time is often delayed. In some patients who are thin, a lump may be palpable on the right side of the abdomen, which requires early medical attention to exclude tumors of colonic origin. Some patients with vague pain in the right side of the abdomen think it is chronic appendicitis and do not pay attention to it, and some patients with chronic diarrhea do not take it seriously because diarrhea is a common symptom of indigestion. The right colon has a very complex anatomy due to its proximity to numerous organs and structures, including the stomach, pancreas, duodenum, ileum, kidneys and ureters, psoas muscle and muscles of the right abdominal wall. The vessels and lymphatic vessels that must be known during radical surgery include the anatomy and variation of the superior mesenteric artery, ileocolon, right colonic artery, mesocolonic artery, common gastrocolic trunk, collateral right colonic vein, right gastroretinal artery, and right gonadal vessels. Lymphatic drainage varies according to the tumor site, but lymph in the paracolon, mesenteric and vascular roots are more fixed drainage sites. An easily neglected area is lymphatic drainage in the head of the pancreas and the subpyloric region of the gastric sinus. This area, with complex anatomy, many variants and easy bleeding, is often contraindicated by surgeons. Therefore, for true radical surgery of right-sided colon cancer, this area is a must. The modified radical right hemicolectomy described in this article focuses on the surgical approaches that need to be eliminated, including the approach from the lateral colonic bypass and the radical approach that ignores the tumor site and tumor-free principle, which may be a medical cause of metastasis after surgery. The modified radical right hemicolectomy I adopted is a summary of a long-term practice, which consists of three major components: 1) lymphatic clearance with the superior mesenteric vessels as the main line, 2) circumferential resection with the tumor as the center, and 3) anatomical pathway with the principle of last, least and shortest access to the tumor. The current emphasis on CME can be complete throughout this procedure. The treatment of colon cancer, including surgery, chemotherapy, radiotherapy and targeted therapy, biological therapy, herbal medicine, etc., so far, surgery is the treatment method that cannot be bypassed. Except for ascending colon cancer that has undergone extensive metastasis, this modified radical treatment method can be the only way to cure the disease, allowing the patient to receive subsequent adjuvant treatment without regret. The following figure shows an example of the local structure after total mesenteric resection for modified radical colon cancer, with postoperative pathology results showing 59 lymph nodes removed, far exceeding international standards. Figure 1 After radical resection of ascending colon cancer, the superior mesenteric vessels and surrounding clearances can be clearly seen. Figure 2 Localization of an ascending colon cancer invading the renal fat capsule, after radical surgery, showing the mesenteric vessels, head of the pancreas, and local clearance around the kidney Figure 3 Localization of a right colon cancer after surgery Figure 4 Localization of an obese patient (hepatic flexure cancer of the colon) after surgery, showing the clearance of the head of the pancreas below the pylorus and other areas Figure 4 Post-operative pathology report of a patient with ascending colon cancer, with a total of 59 lymph nodes cleared (the treatment protocol requires at least 12 lymph nodes).