Colon cancer is the cancer of large intestine (Colon). Depending on the type and size of cancer, its stage and grade, whether it has spread or is confined, and the general health of the patient; the treatment plan is prepared. Surgery is the most common treatment for all stages of colon cancer.
PROCEDURE
It is commonly done under general anaesthesia.
Depending on the stage, the options are -
Local excision: If the cancer is found at a very early stage, a small piece of the intestinal lining may be removed, without cutting through the abdominal wall. If the cancer is found in a polyp, the procedure is called a polypectomy.
Resection: If the cancer is larger, has spread into the surrounding tissues, entire section of colon is removed, termed as Colectomy. Depending on the location, it could be -
- • left-hemi colectomy – where the left half of colon is removed.
- • transverse colectomy – where the middle section of colon is removed.
- • right-hemi colectomy – where the right half of colon is removed.
- • sigmoid colectomy – where the lower section of colon is removed.
The healthy ends of the colon are then sewed together, termed as Anastomosis.
The lymph nodes near the colon are also removed.
Resection and colostomy: If the two ends of the colon cannot be sewed together, the end of the bowel is brought out as an opening (stoma) on the abdominal wall for waste to pass through. This procedure is called a colostomy. A bag is placed around the stoma to collect the waste. Usually the colostomy is needed for a temporary period only until the lower colon has healed, and it is then reversed a few months later. But if the entire or large area of colon has been removed, and it is not possible to sew the ends together, the colostomy may be permanent.
There are two ways a colectomy can be performed:
• In an open colectomy, a large incision is given on abdomen and a section of colon is removed through it.
• A laparoscopic colectomy is a type of ‘keyhole surgery’, where special instruments guided by a camera are inserted through small incisions to remove a section of colon.
If the cancer is too large to be removed and is pressing on the bowel causing it to narrow, a thin metal tube (a stent) is inserted into the bowel to keep it open. This is done with a colonoscope under guided x-ray imaging.
DURATION
Depending on the type of surgery, procedure may take 2 to 4 hours and hospital stay would be of 3 to 7 days.
RECOVERY
The patient is kept on IV fluid to start with, until intestinal function resumes. Liquid diet followed by a soft diet is then started. It is recommended to take a low residue/fibre diet, for about 6 weeks, so as to reduce the amount and frequency of stools and promote healing. It takes approximately two to three weeks to completely resume normal activities. Lifting heavy weights is to be avoided for approximately six weeks.
If surgery involved a colostomy, a proper care of the stoma needs to be taken.
RISKS
- Bleeding
- Infection
- Blood clots in legs/lungs
- Injury to nearby organs
- Leakage from the connection in intestine