Colon Cancer Surgery
When you have a colon cancer diagnosis, figuring out what to do next can be overwhelming. Providence is your partner in navigating treatment options to determine the surgery best suited to your condition. With your personal care plan in mind, your surgeon combines compassionate care and innovative technology to yield the best outcome.
Surgery is the most common treatment for all stages of colon cancer. Depending on the type and characteristics of the cancer, your doctor will determine which method of surgery will be most effective.
If cancers are small, located close to the anal opening and are determined to be of an early state, your doctor may advise local excision. this procedure removes the cancer through the anal opening and avoids an incision in your abdominal wall to reach the rectum. Risks and recovery time are typically lower with this type of procedure. It is not advisable for later stage tumors as it does not remove bowel-associated lymph nodes and may lessen the chance of long-term cure and survival.
Sphincter sparing surgery/Low anterior resection
For larger cancers, surgery involves removing a portion of the rectum through an abdominal incision. Candidates for surgical resection, or removal, are typically treated with a combination chemotherapy and radiation therapy prior to the surgery to decrease tumor bulk, decrease the chance of local recurrence of the cancer and improve long-term survival.
Advances in chemoradiation therapy, in addition to the technical surgical expertise of colorectal surgeons, allow most rectal cancer patients to undergo sphincter sparing procedures which maintain continence, sexual function and normal bowel emptying function.
Abdominoperineal resection (APR)
When rectal cancers involve the sphincter muscle or other pelvic organs such as bladder or vagina, it is not possible to spare the sphincter. In these cases, an abdominal and perineal approach is used to remove the cancer. This necessarily leaves the patient with a permanent colostomy – a surgical opening in the lower abdominal wall through which the colon is attached to allow waste to pass into a bag. Fortunately, few rectal cancer patients require a permanent colostomy.
Colon resection/Partial colectomy
A portion of the colon including the cancer is removed through an abdominal incision. The resection includes a margin of normal colon tissue on either side of the cancer and the lymph nodes associated with that section of intestine. Removing the lymph nodes allows your doctor to determine the stage of your cancer.
Once the cancer is removed, the surgeon connects the two ends of the colon back together to maintain normal intestinal continuity and bowel emptying function. Colostomies are rare in the treatment of colon cancer. Sometimes they are used in cases of obstruction or perforated cancers. In these cases, they are typically temporary and reversible.
Colon cancer that has metastasized (spread to other organs) such as your liver and lung, may sometimes be removed with surgery. This depends on the location of the disease, number of metastatic lesions and your overall medical condition. Complete surgical resection can slow progression of the disease, improve long-term survival and potentially cure you. Surgery is often combined with other treatments, such as radiofrequency ablation or cryosurgery (freezing), locally infused chemotherapy or conventional chemotherapy.
Minimally invasive surgery uses a series of very small incisions (5-10 mm) in the abdominal wall, a camera (laparoscope), and specialized instruments to perform intra-abdominal procedures, such as colon resection. This approach results in shorter hospital stays, faster recovery and faster return to work and other activities of daily living.
Laparoscopic colon cancer surgery has been shown to be equal to open procedures in the length of colon removed, adequacy of number of lymph nodes retrieved and 5-year cancer survival rates. In fact, laparoscopic surgery of colon cancer may even provide a slight survival advantage in certain states of the disease.