Colon Cancer Surgery

Listed below is the step by step procedure of colon cancer surgery:

  1. What is Colon Cancer Surgery?
  2. Why is Colon Cancer Surgery Required?
  3. Pre-operative Preparation
  4. Day Before Surgery
  5. Procedure Day
  6. Methods/Techniques of Colon Cancer Surgery
  7. Post Procedure
  8. Risks and Complications

What is Colon Cancer Surgery?

Colon cancer surgery is a method or approach implemented to treat colon cancer. Colon cancer surgery procedure is different for non-invasive cancer (cancer that has not advanced to later stages) and invasive colon cancer (cancer that has reached to reached later stages) type.

Why is Colon Cancer Surgery Required?

Surgery is one reliable procedure used to treat cancer. Colon cancer surgery is required in case cancer tumor has grown large in size and has penetrated into layers of colon. If other medications and treatments have failed to kill all the cancerous cells present in colon, then surgery is the only option employed to remove malignant tumor (cancerous tumor). It is also a preventive measure to avoid metastasis (spreading of cancerous tumor to other organs) of colon cancer.

Pre-operative Preparations

Prior to the surgery, patients and doctors need to undertake some steps in order to ensure that there are no obstacles during surgery. Some of the pre-operative steps are given below:

  • Discussion: Once it is decided that surgery is the treatment of choice, the surgeon proceeds to obtain the patient's consent. The doctor and patient will discuss all the details regarding surgery, after which the patient provides his/her consent to go ahead with the procedure.
  • Blood tests: Blood tests are performed to assess the levels of white blood cells, red blood cells, hemoglobin, platelets, thyroid hormones, blood sugar etc. All these levels should be normal before the surgery otherwise, it could create complications in the recovery procedure after surgery.
  • Medicines: The doctor discusses with patient about any other medication he/she might be taking for any other health problem. Doses of those medications may be altered if the surgeon feels so. If the patient is having cardiac, liver or kidney disorders, they should inform their surgeon about the same.
  • Alcohol and smoking: It is advisable to stop consuming alcohol or smoking cigarettes completely since a few weeks prior to surgery.

Day before Surgery

Patient may be asked to get admitted to the hospital a day before the surgery. They are asked to avoid consuming any food since the night before surgery. It is important to have an empty digestive tract as the colon will be operated upon. The patient should avoid undue physical or mental stress, and they should try to relax as much as possible before surgery.

Procedure Day

On the day of surgery, you will need to sign a consent form stating about your acceptance of the going ahead with surgery. You will be asked to change to hospital gown and then the anesthetist will administer anesthesia based on the method of treatment to be used.

Methods/Techniques of Colon Cancer Surgery

Based on stages, surgical techniques are implemented for colon cancer treatment. In first two stages, cancer has not metastasized to other organs and is treated using surgical procedures, chemotherapy and radiation therapy. The last two stages of cancer indicate metastasis of cancer to lymph nodes as well as surrounding organs. Cancer at this stage is quite difficult to treat. The last stage of cancer indicates cancer has spread to almost all parts of the body. At this stage, symptoms of cancer can be curbed and oncologist tries to add few years to life of patient. Cancer is not completely treated in last stage.

  • Colon Cancer in Germinating Stages
  • If the size of cancerous tumor is very small, minimally invasive procedures can be implemented to treat colon cancer. Since, in most of the cases, initial growth of cancerous tumor originates from polyps, colonoscopy can be used to treat cancerous cells present in small number in polyps. To treat polyps of larger size, endoscopic mucosal resection surgical procedure is employed.

  • Colonoscopy
  • Colonoscopy involves use of flexible and thin instrument called colonoscope. At one of the end of colonoscope, video camera is attached and that enables doctor to examine structure of entire colon in detail.

    Before colonoscopy procedure begins, doctor will recommend colon preparation procedure for patient. It takes one or two days for preparing colon for colonoscopy. In these days, doctor may put you on a liquid diet and give you a special kind of solution to drink that will help in clearing colon canal.

    Make sure you drink lots of water and fruit and vegetable juices so that your body remains hydrated and you get supply of energy. Consumption of solid foodstuffs is not allowed. Bed rest is advised since patient may experience frequent stools.

    To perform the procedure of colonoscopy, anesthesia will be administered. Colonoscope is inserted into the anus and then guided towards colon and rectum. Polyps are then taken out with help of other instruments like loops, forceps etc. Patient will not feel any sort of pain during the procedure. The procedure takes few hours to complete.

    Post colonoscopy, patient needs to stay int the clinic for few hours. Make sure you drink enough water to recover soon and keep your body hydrated.

  • Endoscopic Mucosal Resection
  • To prepare for endoscopic mucosal resection procedure, fasting is required. You may have to undergo colon cleansing procedure which doctor will prescribe. For a day or two before the surgery, you will have to be on liquid diet. You are not allowed to intake solid food materials. Also, doctor might give you a special solution that will clear colon passage, to drink.

    In endoscopic mucosal resection procedure, patient is administered anesthesia, and endoscope (thin tube) is inserted into the body through anus. It is then guided towards the rectum and colon region where large polyps are located. To remove these larger polyps, part of colon lining may also be removed. The surgery may last for few hours.

    Post endoscopic mucosal resection procedure, patient is advised to take bed rest. Doctor might suggest you to restrict intense physical activities.

  • Laparoscopic Surgery
  • Laparoscopic surgery procedure is implemented when polyps are not completely eliminated through colonoscopy. Before the procedure of laparoscopic surgery begins, colon cleansing will be recommended. You have to be on liquid diet for a day or two as per your doctor's instructions.

    Laparoscopic surgery to treat colon cancer is a minimally invasive procedure which means there is less wearing and tearing of tissues during surgery. Few small incisions are made on lower abdominal region through which laparoscope is inserted. Laparoscope is a thin, long tube with attached video camera at its one end. This video camera helps oncologist view colon on video monitor. During this procedure, samples of colon tissue and surrounding lymph nodes may also be taken to diagnose metastasis. Laparoscopic surgery takes approximately an hour or so to get completed.

    Once laparoscopic surgery is done, patient can return home after staying for few hours in hospital.

  • Surgery for Invasive Colon Cancer (Advanced Stage of Colon Cancer)
  • Surgical procedure adopted to treat colon cancer that has advanced to further stages i.e., the malignant tumor has penetrated deep inside the layers of colon. Hence, treatment method adopted to treat cancer at this stage is different from the previous stage.

    Surgical method adopted to treat colon cancer in advanced stage is more complex than the one that is adopted to treat non-invasive colon cancer. Let us understand treatments employed to treat colon cancer that has advanced to later stages.

  • Colectomy
  • Colectomy is a surgical procedure employed to remove either entire or a small part of colon. It is classified into four categories - total colectomy, partial colectomy, hemicolectomy and proctocolectomy.

  • Total Colectomy
  • As per the name, total colectomy involves removal of entire colon from ileum (lowest portion of small intestine) to rectum. This surgical method is adopted if the cancerous cells have invaded entire colon and there could be a risk of the tumor spreading to surrounding healthy tissues.

    Before the procedure of total colectomy begins, you need to discuss some issues, such as pregnancy, sexual intimacy, sports and work, with your doctor. It may happen that doctor may put some restrictions on these factors. Your oncologist will chalk out an entire plan on precautions to be taken a week prior to the surgery, day before the surgery and on the day of surgery. Generally, week or two before colectomy, you are encouraged to consume foods rich in fiber and intake of high amounts of healthy fluids such as coconut water and fruit juices.

    To perform total colectomy, general anesthesia will be administered. Surgeon will then make a cut on abdomen to remove large intestine. Once, the procedure gets completed, end of small intestine will be sewed to rectum.

    Post total colectomy, patient will be required to stay in the hospital for at least a week. Doctor will advise when you can start intake of solid foods, but till then you will have to remain on liquid diet.

  • Surgery for Creation of an Outlet for Waste Materials
  • Since total colectomy involves removal of entire colon, an outlet has to be created for waste materials to get out of the body. The surgery comprises of creating an opening in abdominal wall from a portion of remaining bowel. This enables waste materials to be eliminated from body into a special bag.

  • Partial Colectomy
  • In partial colectomy, precautions to be taken before the surgery and post surgery remain quite similar. The only difference between total colectomy and partial colectomy is that in the latter, only the affected part where cancerous growth is found is removed. Other surrounding healthy tissues might also be removed in order to ensure complete removal of cancerous cells.

  • Proctocolectomy
  • This surgical procedure is employed when cancerous tumor has spread to rectum. In this surgery, entire colon as well as rectum is removed.

    Therapies to treat advanced cancer:

    Therapies that are generally used to treat cancer in advanced stage are radiation therapy, chemotherapy and targeted drug therapy.

Along with the above explained methods, chemotherapy and radiation therapy are also required as per requirement.

Post Procedure

Following colon cancer surgery, the patient usually remains in the hospital for 2-4 days. During the hospital stay, patient is examined and observed for any abnormal health changes.

It takes about 6-8 weeks for complete recovery post surgery. A diet plan will be given to the patient and it is a must to adhere to the plan. If nothing specific has been told about diet, patients can seek help from a professional dietitian. Smoking and alcohol are to be strictly stopped after surgery. If the patient has undergone colostomy, they will be wearing a colostomy bag where stool gets accumulated. This bag should be cleaned a regular intervals to avoid chances of developing infection at the open end of intestine.

The patient must follow up with the surgeon at regular intervals. Sometimes follow up MRI, CT scan or other investigations can be advised to check for recurrence of cancer.

Proper follow up and medical advise goes a long way in recovery after colon cancer surgery

Palliative Care

Palliative care covers all the treatment methods used for symptomatic relief in cancer. It is usually the most suitable treatment In case of incurable colon cancer. The treatment in such cases is targeted towards reducing the intensity of cancer symptoms and provide better quality of life to the patient.

It could be surgical treatment, medical treatment or radiation therapy. Many patients having colon cancer experience altered stool habits due to the growing tumor in the colon which blocks the digestive tract. Removal of the tumor does not reduce cancer, but helps in reducing digestive troubles faced by the patient. This type of treatment could be used in patients along with mainstream cancer treatment.

Risks and Complications

Some of the common complications and risks involved in colon cancer surgery are:

  • Bleeding: If the patient has undergone major colon cancer surgery, bleeding could be a possible consequence. Both partial as well as total colectomy involve high amount of blood loss. If the patient falls short of blood, blood transfusion might be needed.
  • Infection: Since colon cancer surgery is an invasive procedure, the chances of infection increase during and after surgery. The paient might complain of abdominal pain, blood in stool and fever in case of infection. Anti-biotics and pain killers are administered in such cases to provide relief from infection.
  • Bowel and bladder problems: For few initial days post surgery, patient may experience bowel and bladder problems. But, these problems may fade away after a certain period. If this problem continues, it is important that you consult with your oncologist.
  • Injury to nearby organs: While performing colectomy, injury might happen to surrounding organs. Nearby organs, such as spleen, urinary bladder and uterus might become damaged.
  • Sexual complications: Sexual complications might arise post colon cancer surgery. Men will experience pleasure, but ejaculation might not happen. Women might experience dry orgasms.
Above mentioned complications should be discussed with doctor in order to ease them. Doctor will provide you appropriate guidance.

Hope, the above mentioned article helps colon cancer patients in answering their queries. Its important that one takes necessary precautions right from beginning in order to reduce symptoms of cancer. Early detection of cancer helps tremendously in clearing symptoms and making the procedure of colon cancer treatment less painful and less complicated.

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