Surgical procedures Your surgeon removes the part of your colon that contains the cancer, along with a margin of normal tissue on either side of the cancer to help ensure that no cancer is left behind. Nearby lymph nodes are usually also removed and tested for cancer.
Your surgeon is often able to reconnect the healthy portions of your colon or rectum. But when that’s not possible, for instance if the cancer is at the outlet of your rectum, you may need to have a permanent or temporary colostomy.
This involves creating an opening in the wall of your abdomen from a portion of the remaining bowel for the elimination of body wastes into a special bag. Sometimes the colostomy is only temporary, allowing your colon or rectum time to heal after surgery.
In some cases, however, the colostomy may be permanent. In cases of rare, inherited syndromes such as familial adenomatous polyposis, or inflammatory bowel disease such as ulcerative colitis, you may need removal of your entire colon and rectum as a prophylactic measure.Then, in a procedure known as ileal pouch-anal anastomosis, your surgeon will likely construct a pouch from the end of your small intestine that attaches directly to your anus. This allows you to expel waste normally, although you may have several watery bowel movements a day.
Side effects of colon cancer surgery may include short-term pain and tenderness, and temporary constipation or diarrhea. If you have a colostomy, you may develop an irritation on the skin around the opening (stoma). If your cancer is small, localized in a polyp and in a very early stage, your surgeon may be able to remove it completely during a colonoscopy. If the pathologist determines that the cancer in the polyp doesn’t involve the base — where the polyp is attached to the bowel wall — then there is a good chance that the cancer has been completely eliminated. Some larger polyps may be removed using laparoscopic surgery. In this procedure, your surgeon performs the operation through several tiny incisions in your abdominal wall, using small instruments with attached cameras that display your colon on a video monitor.
He or she may also take samples from the lymph nodes that drain the area where the cancer is located. Studies have found that people undergoing this procedure need less pain medication and leave the hospital a day earlier on average. Also, people who have this procedure don’t have higher rates of recurrence than those who choose the open surgery.
If your cancer is advanced or your health poor, only a small portion of your colon or rectum may be removed. This isn’t as effective as surgeries that remove more tissue, and doctors mainly do this to relieve blockages or bleeding. This is referred to as palliative surgery; it isn’t curative.
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