Surgical Oncology and Colorectal Surgery

Colon and Bowel Surgery

Nurse in the operating room smiling with doctor and patient in the background

Colon and Rectal Cancer is a form of cancer that has developed in the tissue of the colon (the longest part of the large intestine) or the rectum (the last part of the large intestine). Most colon cancers are adenocarcinomas (cancers that begin in the cells that make and release mucus and other fluids) and when found early with colonoscopy may be treated with local resection alone.

Treatments offered: Surgery, radiation, chemotherapy

Colon and Bowel Surgery in the field of Oncology Surgery Specialist

Oncology surgery specialists often perform colon and bowel surgeries. Most of the time, these surgeries involve a blockage in the intestines. The specialist must determine the best course of action and then perform the operation. The primary impetus for this kind of surgery involves polyps that may or may not be cancerous.

Most of the time, open colon surgery involves a long incision in the abdominal region. When possible, the oncology surgery specialist will opt to perform a laparoscopic colon resection.

Laparoscopic Colon Resection

This type of surgery is less invasive because it involves a few small incisions in the abdomen rather than one large one. The surgeon will operate through the incisions while watching the patient's organs on a monitor.

There are a number of benefits to having this type of surgery:

  • Less pain after surgery
  • Shorter time spent in the hospital
  • The patient will be able to eat solid food and have normal bowel functions sooner
  • Less scarring

Bowel Obstructions

Bowel obstructions are usually the reason for surgery. Sometimes, a stool hardens in the intestines and is difficult to pass. Those can generally be handled with over the counter remedies.

Sometimes, bowel obstructions are caused by colon cancer or stomach cancer. Most of the time, it is the small intestine that is blocked off. A tumor can grow inside or outside the intestines and cause blockages. Bowel obstructions often occur in the latter stages of cancer. Colon cancer is broken into four stages. In stage IV, the cancer cells spread to other organs.

Large Bowel Resection

A resection is often done for those with obstructions. This surgery is sometimes also known as a colectomy. The resection is done to remove a section the patient's large bowel. This could involve the colon, the rectum, or both.

There are quite a few reasons for this surgery:

  • Colon cancer
  • Intestinal blockage
  • Physical injuries that have damaged the large bowel
  • Polyps that are not cancerous
  • Gastrointestinal bleeding
  • Ulcerative colitis

Once the surgery is done, the patient will stay in the hospital for up to one week. The stay could be longer if there are complications. The patient should be able to drink clear liquids after a few days. Food can be consumed once the bowel starts to work again.

Most of the time, patients recover fully and are able to resume a normal life even with a colostomy.

Colon Cancer

Colon cancer develops in a series of stages. In the latter stages, the cancer cells travel through the blood and lymph nodes to attack other organs like the lungs.

There are two types of surgical procedures to deal with colon cancer. Local excision is used for cancer in the early stages. The oncology surgery specialist can remove these tumors without making any incisions in the abdominal wall.

The other type is a resection of the colon. The oncology surgery specialist will remove the cancer and a bit of the non-cancerous tissue around it. After that, the doctor may also sew the colon back together, which is a process known as anastomosis. Often the doctor will also remove some lymph nodes and test them to see if they are cancerous.

If the oncology surgery specialist is unable to reattach the two ends of the colon, they will put a stoma in the body. The stoma delivers waste to an exterior colostomy bag. The colostomy bag is not necessarily permanent. Sometimes the lower intestine heals itself and the stoma can be removed.

Cryosurgery

Sometimes, an oncology surgery specialist will freeze and destroy infected tissue. Drugs are used to halt the growth of cancer cells. Chemotherapy is delivered via injection or pill. The drugs enter the bloodstream and battle the cancer cells. The chemo treatment might be injected directly into the abdomen, which is a process known as regional chemotherapy.

Colon Cancer Surgery Recovery

The recovery period could take quite a long time. For some, it takes about two months before they can resume normal activities. Patients should be aware that when they wake up, they will be connected to machines and will be unable to walk, sit up or even move around. That lasts just a day or so, and improvement is usually rapid.

Colon Cancer Surgery Complications

Sometimes there will be aftereffects of the surgery. This might include sexual dysfunction or blood clots. Some men have trouble urinating and need a catheter for a while. Some people become depressed or have panic attacks.

Some patients will develop adhesions, which might cause another blockage that will need to be removed with another surgery. Adhesions are scars or inflammation that sometimes twists on them, which can obstruct the small intestines.

Colon Cancer Surgery Survival Rate

A patient's age and overall health are a major factor in surviving colon cancer. These are the five-year survival rates for those who have colon cancer surgery:

  • Stage I colon cancer: 92%
  • Stage IIa colon cancer: 87%
  • Stage IIb colon cancer: 63%
  • Stage IIIa colon cancer: 89%
  • Stage IIIb colon cancer: 53%
  • Stage IIIb colon cancer: 53%
  • Stage IV colon cancer: 11%

Colon and bowel surgery is a very specific field that requires a lot of knowledge and training. Oncology surgery specialists make it their goal to be precise and successful in each and every operation.