Surgical Treatment For Colon Cancer
SURGERY FOR COLON CANCER
Surgery is often the main treatment for early-stage colon cancers. The type of surgery used depends on the stage (extent) of the cancer, where it is in the colon, and the goal of the surgery.
Any type of colon surgery needs to be done on a clean and empty colon. You will be put on a clear liquid diet before surgery and may need to use laxative drinks and/or enemas to get all of the stool out of your colon. This bowel prep is a lot like the one used before a colonoscopy.
Polypectomy and local excision
Some early colon cancers (stage 0 and some early stage I tumors) and most polyps can be removed during a colonoscopy. This is a procedure that uses a long flexible tube with a small video camera on the end that's put into the person’s rectum and eased into the colon. These surgeries can be done during a colonoscopy:
For a polypectomy, the cancer is removed as part of the polyp, which is cut at its base (the part that looks like the stem of a mushroom). This is usually done by passing a wire loop through the colonoscope to cut the polyp off the wall of the colon with an electric current. This is called snare polypectomy.
A local excision is a slightly more involved procedure. Tools are used through the colonoscope to remove small cancers on the inside lining of the colon along with a small amount of surrounding healthy tissue on the wall of colon. This is called sub mucosal resection of polyp.
When cancer or polyps are taken out this way, the doctor doesn't have to cut into the abdomen (belly) from the outside. The goal of either of these procedures is to remove the tumor in one piece. If some cancer is left behind or if, based on lab tests, the tumor is thought to have a chance to spread, a type of colectomy (see below) might be the next surgery.
A colectomy is surgery to remove all or part of the colon. Nearby lymph nodes are also removed.
If only part of the colon is removed, it's called a hemicolectomy, partial colectomy, or segmental resection. The surgeon takes out the part of the colon with the cancer and a small segment of normal colon on either side. Usually, about 8-10 inches of the colon is removed, depending on the size and location of the cancer. The remaining sections of colon are then reattached. At least 12 nearby lymph nodes are also removed so they can be checked for cancer.
If all of the colon is removed, it's called a total colectomy. Total colectomy isn't often needed to remove colon cancer. It's mostly used only if there's another problem in the part of the colon without cancer, such as hundreds of polyps (in someone with familial adenomatous polyposis) or, sometimes, inflammatory bowel disease.
How colectomy is done
A colectomy can be done in 2 ways:
Open colectomy: The surgery is done through a single long incision (cut) in the abdomen (belly).
Laparoscopic-assisted colectomy: The surgery is done through many smaller incisions and special tools. A laparoscope is a long, thin lighted tube with a small camera and light on the end that lets the surgeon see inside the abdomen. It's put into one of the small cuts, and long, thin instruments are put in through the others to remove part of the colon and lymph nodes.
Because the incisions are smaller in a laparoscopic-assisted colectomy than in an open colectomy, patients often recover faster and may be able to leave the hospital sooner than they would after an open colectomy. But this type of surgery requires special expertise, and it might not be the best approach for everyone. If you're considering this type of surgery, be sure to look for a skilled surgeon who has done many of these operations.
Overall survival rates and the chance of the cancer returning are much the same between an open colectomy and a laparoscopic-assisted colectomy. But the minimally invasive laparoscopic surgery provides faster recovery and quicker return to work and normal functions.
Khawaja Azimuddin M.D. & Tal Raphaeli M.D. & Jean Knapps M.D.
1125 Cypress Station Dr, Suite G, Houston TX 77090
Tel: 281-583 1300 Fax: 281-583 1303
Houston Colon & Rectal surgery PA
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