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Surgery for Colon and Rectal Cancers

Colectomy

Colectomy is the most common procedure performed to remove the cancer cells. It is the surgical resection of all or part of the large intestine. It is also called large bowel resection. Colectomy is performed under general anaesthesia by open surgery method or by laparoscopic method. The procedure takes about 1 to 4 hours.

Open colectomy

In this technique a single large incision of about 6 inches is made in the lower abdominal wall. The diseased part of the colon is removed and the healthy ends are sutured. If no healthy large intestine is left, an opening or a small incision called a stoma is created on the abdominal wall. The open end of the large intestine is stitched to the skin of the outer wall of the abdomen. Wastes will pass through this opening into a bag that is attached outside the body. This procedure is called colostomy.

Laparoscopic colectomy

It is a minimally invasive technique where several small incisions are made rather than one large incision. Three to five small incisions are made on the lower abdomen. A laparoscope, a telescopic video camera is used to see the inside of the abdomen, is inserted through an incision. Small surgical instruments are passed through other 2 incisions and colon is removed. Carbon dioxide (CO2) gas is filled in the lower abdomen and expanded for easy access and the diseased part of the colon is removed. The healthy ends are reattached and all the incisions are closed with the sutures.

Complications of colectomy procedure include infection at the site operated, bleeding, and damage to nearby organs.

Some of the ways to prevent the colon cancer include high fiber diets and vitamins, avoid smoking and alcohol consumption, lose weight in case you are obese, and a healthy life style can lessen risk of colon cancer.

Laparoscopic Colorectal Surgery

Laparoscopic colorectal surgery is a technique which involves operations on the colon and rectum through 4 or 5 small incisions. A laparoscope (a narrow tube having a tiny camera) is inserted through the incision which gives the surgeon, an enlarged image of the internal organs on a television screen.

Colorectal conditions that can be treated using laparoscopy include:

  • Diverticular disease (diverticulitis)
  • Appendicitis
  • Rectal polyps
  • Rectal cancer
  • Severe constipation
  • Rectal prolapse (relaxed/unsupported rectal tissue)
  • Colon volvulus (twisting or displacement of the intestines)
  • Inflammatory bowel disease (Crohn's or ulcerative colitis)

Procedure

The surgical procedure is performed in a hospital under general anesthesia. Several small incisions (3 to 5) which are less than 0.5 cm are made in the abdomen. Trocar (narrow tube-like instrument) is placed through these openings. A laparoscope is inserted through one of the trocars, which gives an enlarged view of the internal organs on the television screen. The surgery is performed through the others trocars by inserting special instruments or by enlarging one of the incisions to remove part of the colon.

Preparation for Surgery

Preparation for colorectal surgery involves cleansing the colon or "bowel preparation". Your surgeon will prescribe an enema and antibiotics following which you should not eat solid food for 8 hours before the surgery. You will be advised to discontinue your regular medications such as blood thinners, warfarin, aspirin or ibuprofen.

Post-operative Care

You can resume normal activities in one or two weeks following the surgery. You can start walking the next day of your surgery. Loose stools are normal for the first two weeks after surgery. Seek medical help if you come across following conditions:

  • Watery stools for more than 3 days.
  • Nausea and vomiting
  • Pain in your abdomen
  • Pus discharge or redness around your incision
  • Fever with chills (temperature of 100.5 or higher)
  • Bleeding from the rectum
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