SURGERY

Surgery, local excision, or resection is the most common treatment for colorectal cancer. Surgical techniques have improved greatly in the past few years. 

 

There are two main types of surgery: 
 

Laparoscopy

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Many colon cancers may be removed with the aid of a thin, lighted tube -- a laparoscope. Three or four tiny cuts are made into your abdomen. The surgeon sees inside your abdomen with the laparoscope. The tumor and part of the healthy colon are removed. Nearby lymph nodes also may be removed. The surgeon checks the rest of your intestine and your liver to see if cancer has spread. There are significant advantages to have this form of minimally invasive surgery, including shorter hospital stays, less risk of infection, significantly less scarring, less readmission to hospitals and quicker recovery. Recent medical literature shows this form of surgery is at least equally as effective as traditional open surgery. The problem is locating a surgeon who does this form of surgery. Most surgeons are not trained for minimally invasive surgery, but if patients insist on this form of surgery, physicians will have to learn these procedures…so find out if you are a candidate for this type of surgery and insist on having it! Check out these videos done by the US-based Colon Cancer Alliance for a physicians and patient’s perspective on these surgeries.

 

Open Surgery

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With this common procedure, the surgeon makes a large cut into your abdomen to remove the tumor and part of the healthy colon or rectum. Some nearby lymph nodes are also removed. The surgeon checks the rest of your intestine and your liver to see if the cancer has spread.

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A summary of the surgical terms:

 

• Local excision—when the cancer is in a very early stage, the doctor can remove it without making a cut or incision on the abdomen. The doctor will put a tube into the colon and cut the cancer out through the tube. If the cancer is found in a polyp the surgery is called a polypectomy.

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• Resection—if the cancer is larger, the doctor will perform a partial colectomy. This means removing the part of the colon where the cancer is and part of healthy tissue surrounding the cancer. The doctor may then do an anastomosis, which is sewing the healthy parts of the colon together. The doctor will usually remove lymph nodes near the colon and examine them under a microscope to see if they contain cancer cells.

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• Resection and colostomy—if the doctor is not able to sew the two ends of the colon back together, an opening (stoma) is made on the outside of the body for bowel movements to pass through. This operation is called a colostomy. A bag is connected to the stoma to collect the waste. Colostomies sometimes are needed only until the lower colon has healed, then the colon can be sewn back together. Sometimes, however, a colostomy is permanent.

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Source: The University of Iowa:

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Post Surgery

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Regardless of whether you have open surgery or a minimally invasive procedure, you’ll need time to heal. If you had a colon resection, you will not be able to eat for the first couple of days and will be given intravenous fluids and pain medication. You’ll probably feel tired and weak, and possibly have slight constipation for some time after colon surgery.