Colonic surgery

Surgical removal of the tumor and a piece of tissue is the most common form of treatment of colorectal cancer.

Operation

Your doctor will discuss with you about the surgical procedure, depending on the stage of the cancer and its location in the intestine.

During the surgery, a part of the bowel containing the cancer is removed and then the two open ends of hose go back together. This compound is called anastomosis. The lymph nodes near the intestine are removed, because these are the most common places to which the cancer begins to spread.

Surgery of rectal cancer

People who have rectal cancer are more likely to need a permanent colostomy than people who have colon cancer. The reason is that it is much harder to leave enough healthy bowel whose ends can re-connect when it comes to rectal cancer. This especially refers to tumors of the lower third of the rectum. Radiotherapy, chemotherapy or radiation before surgery, may help to reduce the size of the tumor and this may reduce the likelihood of the need for a permanent colostomy.

Total meso-rectal excision (TME) is a procedure that is commonly used for the removal of rectal cancer. This involves carefully removing the entire rectum and fat tissue that surrounds it, which includes the lymph nodes. For this operation, it takes three to five hours. Studies have suggested that the TME is better than other forms of surgery and reduces the risk of recurrence.

Depending on the position of the tumor in the rectum, its size and distance from the anal opening (sphincter), a surgeon will perform the surgery or TME either by anterior resection or through the abdominal-perineal resection.

Anterior resection is usually done for tumors in the upper rectum (close columns). At this point you will have a wound similar to the one colectomy leaves.

Abdominal-perineal resection is usually done with tumors in the lower end of the rectum. This operation results in a permanent colostomy because the entire rectum and anus are removed. After surgery, there are two wounds remaining – the abdominal wounds and other wounds at the point where the anus was surgically removed.

The anus carcinomas, at very early stages can sometimes be removed by surgery known as local resection or transanal resection. Using an endoscope, similar to that used to perform a biopsy, a surgeon will remove the tumor from the colon wall. If the tumor is near the anus, the surgeon may not even have to use the endoscope during an operation. The second operation may be needed to remove the intestine around the place where the tumor was situated. This is recommended if it turns out that the tumor is nevertheless high grade and there is a risk that some cancer cells remain.