Colorectal Surgery

Colorectal surgery is often the recommended course of treatment for certain diseases such as colorectal cancer, diverticular disease, intestinal blockage due to scar tissue, ulcerative colitis that does not respond to medication, and traumatic injuries and polyps.

Polyp Removal

Polyps are a small cluster of cells that form on the lining of the colon or the large intestine. Most polyps are not cancerous and are simply a result of abnormal cell growth, but some can gradually turn into colon cancer, so regular screening and removal of all polyps is important. The polyps are removed using a thin, flexible device such as an endoscope with small tools. The tissues are then tested in a lab to determine whether they are cancerous or not.

Colorectal Surgery

Prior to colorectal surgery, the colon may need to be cleaned with an enema or oral agent. Then, the patient is put under general anesthesia. A series of small incisions are made in the abdomen through which an endoscope and surgical instruments are inserted. Working through these tiny incisions with the help of the endoscopic camera, the surgeon removes the diseased intestine and sews the remaining ends together. The incisions are then stitched closed.

In cases of cancer, some normal tissue on each side will be removed as well to ensure no cancer is left behind. For some patients, chemotherapy and/or radiation will be part of the treatment along with surgery. The prognosis for colorectal cancer discovered in an early stage is very good, with an 80 to 90 percent recovery rate. After undergoing colorectal surgery, most patients return home within a week. Full recovery generally takes up to two months.

As for any surgery, risks include allergic reaction to anesthesia, bleeding, infection and breathing problems. Specific risks include hernia at the incision site, narrowing of the stoma, intestinal blockage due to scar tissue, leakage at the resection site and need for colostomy bag.

Colostomy

A colostomy is a surgical procedure performed to attach the end of the large intestine to the abdominal wall to compensate for the loss of the colon, anus and/or rectum. This allows the stool to be collected in the bag attached to the abdomen.

Temporary colostomies are performed after corrective/repair surgery is performed on the colon or rectum that requires a certain period of "rest." In these cases, the colostomy is reversed once these structures are healed and fully capable of passing feces as normal.

Colostomies are performed through open surgery, which requires general anesthesia. Risks include bleeding, wound reopening, infection and anesthesia complications. Once the colon/anus has been removed and the rest of the intestine rerouted to the skin surface, a stoma collecting bag is attached at the site. The patient is then instructed of its use during their stay in the hospital, which lasts about a week.

Ileostomy

Ileostomy is a bowel diversion surgery similar to a colostomy, which redirects the end of the small intestine (ileum) to the superficial layer of the skin where it is affixed. A collection apparatus is attached to the opening, which can either be changed when full or drained during normal bathroom visits. Ileostomies are generally performed on patients who have lost large intestine functionality due to cancer or another disease. Patients are able to return to normal activities with relatively few restrictions and much better control over their bowels.

Besides the risks common to all surgeries, such as blood clots, internal bleeding and infection, several risks are unique to this surgery including:

• Scar tissue blocking intestine
• Reduced absorption of nutrients
• Increased susceptibility to dehydration
• Wound reopening
• Infection/damage of surrounding organs

Post-Surgery

It is very important for anyone who has undergone a colorectal surgical procedure to have regular follow-up appointments with their physician, especially in cases of cancer. Even if every trace of cancer appeared to be removed successfully, undetectable cancer cells may be present nearby or in another part of the body. Regular examinations and testing will help to ensure that there has been no recurrence of the cancer or, if a malignancy is once again discovered, it will be found and treated in its earliest stage.

Post-operative check-ups will be most frequent within the first two years after the surgery as this is the most likely window for a return of the cancer. You may be required to have appointments every two to three months during this period. The examinations may consist of blood tests, flexible sigmoidoscopy, colonoscopy, X-rays and other forms of imaging.

Content presented on this website is for general information only. The healthcare provider | Abner Glover M.D. | is not responsible for any content selection, or any errors, inconsistencies, or outdated information.