Surgical treatment is the most usual treatment for colon cancer and also might range from minimally invasive, such as excising a polyp throughout a colonoscopy, to, in rare instances, getting rid of the whole colon. Many surgeries for colon and rectal cancer involve getting rid of cancer, the section of the colon in which the cancer was found, surrounding normal tissue as well as close-by lymph nodes. This is the basic principle used for all cancer surgeries of colon and rectum irrespective of whether open or minimally invasive surgical procedure is used.
People may get chemotherapy treatment and/or radiation treatment before and/or after surgical procedure for rectal cancer. These adjuvant therapies may help diminish tumours prior to they are surgically gotten rid of and are intended to target cancer cells that may continue to be after surgical treatment. Such a choice will depend on the clinical staging of the cancer
Local excision and polypectomy
- If colon or rectal polyp or cancer is found at an early stage, it can be removed, with a colonoscope. It is a excision that does not need puncturing the abdominal wall. If the excision includes the removal of a polyp, the treatment is called a polypectomy. This is also used to remove pre malignant lesions and thus need for surgery is avoided.
- During these procedures, a physician accesses the colon or rectum with a colonoscope as well as a connected cutting tools used to remove the polyps or unusual cells. If a polyp or location of uncommon cells cannot be excised through these treatments, laparoscopic or open surgery may be needed.
Colectomy: Total or Hemicolectomy
- A colectomy is the removal of all or part of the colon. The resection might be carried out as a less intrusive laparoscopic colectomy. If open surgery is needed, a lengthy incision in the abdomen might be required. With open surgery, patients will remain in the hospital for a week or more and might have a longer period of recovery. Early discharge is possible with laparoscopic or open surgery.
Laparoscopic surgery for Colon Cancer
- Colorectal surgeon will carry out a laparoscopic colectomy to get rid of the malignant part of the colon and also neighbouring lymph nodes, and afterwards reattach the healthy ends of the colon. A laparoscopic colectomy may result in less pain, a shorter stay in the health centre and also a speedier recovery.
- With a laparoscopic colectomy, about 4 to 5 tiny lacerations are made around the abdomen. The medical oncologist after that inserts a laparoscope, a thin tube outfitted with a small video camera that projects photos of the within the abdominal area on a nearby screen. The colorectal surgeon after that inserts tools via these small cuts to do the surgery.
Types of Colectomy used for Colon Cancer
The type will depend upon the location and extent of the tumour. This will also depend on the number of tumours found in the colon. Based on above these could be:
- Total Colectomy
- Subtotal Colectomy
- Right Hemicolectomy
- Right Extended Hemicolectomy
- Left Hemicolectomy
- High Anterior Resection
- Sigmoid Colectomy
Colostomy for colon cancer
A colostomy may be needed, relying on the kind as well as degree of the colon surgical treatment carried out. During this procedure, the colon is linked to a hole in the abdomen (called a stoma) to draw away faeces from a damaged or surgically fixed part of the colon or anus. Some colostomies may be reversed as soon as the repaired tissue heals.
Various other colostomies are irreversible, as well as the stoma is affixed to a colostomy bag that accumulates waste. These are called permanent colostomies and are used for very low rectal cancer which is near the anus and the sphincters are involved.
- A proctectomy is used to get rid of all or part of the rectum. A low-anterior resection entails the removal of rectum for cancer located in the top part of the rectum, which is closest to the S-shaped sigmoid colon. Some surrounding healthy rectal tissue may likewise be eliminated, in addition to nearby lymph nodes and also fatty tissue. This surgery involves a joint made with special staplers and the colostomy used is temporary.
- A pathologist will analyse the lymph nodes to identify if cancer cells are present. This will certainly aid physicians identify the stage of the disease and also whether chemotherapy and or radiotherapy is required.
- After the cancerous section of the rectum is eliminated, the colorectal oncologist links the sigmoid colon with the remaining healthy part of the rectum below the cancer. This allows waste to pass typically out of the body through the anus, once the temporary stoma is removed.
- Abdominoperineal resection (APR) is made use of to deal with cancer in the lower rectum. Since this treatment needs removal of the cancerous section of the lower anus nearest the anus, some or every one of the anal sphincter is likewise gotten rid of. The sphincter is a muscle that maintains the anus shut and protects against stool leak. Since the sphincter is in charge of digestive tract control, the colorectal surgeon additionally carries out a colostomy to enable the body to secrete waste.
Laparoscopic or Robotic Surgery for rectal cancers
- All kind of proctectomies in including APR are also done by these procedures. Robotic surgery gives an edge over laparoscopic surgery as it has better magnification and is more precise in limited spaces. However open surgery may be required for larger or fixed tumours of the rectum.
HIPEC for Colon Cancer
- Hyperthermic intraperitoneal radiation treatment (HIPEC) is an extremely focused, warmed chemotherapy therapy that is supplied directly to the abdominal area throughout surgery.
- Unlike systemic radiation treatment distribution, which distributes throughout the body, HIPEC may supply chemotherapy directly to cancer cells in the abdomen. This allows for higher dosages of chemotherapy therapy.
- HIPEC might be especially practical for people with colon cancer or rectal tumours that have not involved organs such as the liver or lungs, or to lymph nodes outside the abdominal cavity.
Plenty of options are available for treating colon and rectal cancer.
Laparoscopic or Robotic surgery are preferred options.
Open surgery is used for larger or advanced cancers.
Choice of surgery will depend on many factors.
Discuss all the above with your colorectal surgeon.