Surgeons often perform this surgery for bowel cancer but it might also be used to treat other conditions such as:
- Diverticulitis
- Inflammatory bowel disease such as Crohn’s disease or ulcerative colitis
- A benign tumour
- An injury or obstruction
What is Bowel Cancer?
Bowel cancer, also known as colorectal cancer, can affect any part of the large bowel (colon) or rectum. Depending on where the cancer is located, it may also be referred to as rectal cancer or colon cancer.
Most bowel cancers start as benign growths called polyps. They are usually harmless but can develop into cancerous (malignant) tumours.
Symptoms may include:
- Blood in the stool or rectal bleeding
- A recent change in bowel habit e.g. diarrhoea
- Unexplained anaemia
- Abdominal pain or swelling
- Lump or pain in the anus or rectum
During the early stages of bowel cancer patients may have no symptoms.
Why do I need surgery?
There are a number of conditions which might require colorectal surgery. The most common is bowel cancer. Most cases of bowel cancer can be successfully treated when detected early. As a cancerous tumour grows it can narrow and block the bowel. Bowel cancer can spread (metastasise) beyond the bowel to other organs.
Surgery
There are different ways of doing colorectal surgery.
Instead of cutting into the abdomen the surgeon can insert an endoscope into the rectum and lower colon. Early stage polyps and tumours are often cut out in this way.
Minimally invasive surgery, also called laparoscopic or keyhole surgery is often recommended for early stage cancers. Several small incisions are made in the abdomen. A thin, flexible tube fitted with a camera is inserted into one of the incisions. This allows the surgeon to see inside the abdomen and perform surgery.
The most common type of surgery is called a colectomy but operations can have different names depending on how much of the colon, rectum and anus is removed. The surgeon cuts into the abdomen below the naval. If only a section of the colon is removed the two ends are usually re-joined with stitches or staples.
Sometimes a procedure called a colostomy is performed. Instead of joining the bowel the surgeon makes an opening in the abdomen and brings the end of the bowel out through the hole. The opening is called a stoma. Another operation to re-join the bowel can be done later or the stoma could be permanent.
What you can expect?
Bowel preparation (cleaning) and fasting is required before surgery. Endoscopic surgery is usually performed under a light anaesthetic so patients can go home that day. Laparoscopic surgery and open surgery will require a hospital stay. The average stay in hospital for open surgery is 5-10 days. Laparoscopic surgery usually has faster recovery times.
Risks
The main risks of colorectal surgery are:
- Bleeding
- Injury to other organs and parts of the bowel
- Sexual dysfunction
- Intestinal adhesions (scar tissue)
- Anastomotic leak. A leak might occur where two pieces of bowel have been cut and re-joined
Prognosis
It is difficult to generalise about the results of colorectal surgery as it might be performed for a number of reasons. It can take 6 weeks to recover. There can be changes in bowel function which will usually improve after a few months. If bowel cancer was removed the success of the surgery will depend on a number of factors including how advanced the cancer was.