What are the different types of colorectal surgery?
In the realm of colorectal cancer, surgery often emerges as a crucial chapter in the fight against this formidable adversary.
To empower individuals facing such a diagnosis, it becomes imperative to possess a thorough understanding of the diverse types of colorectal surgery.
In this blog, we’ll explore various types of colorectal surgery, shedding light on their purposes and procedures. Whether you’re dealing with this challenge yourself or supporting someone you care about, we’re here to make colorectal cancer surgery a bit easier to understand.
Different types of colorectal cancer surgeries
Colorectal surgeries are diverse and depend on factors such as the stage of cancer, location, and the overall health of the patient. Here are some common colorectal cancer surgery types:
Local excision:
A local excision involves removing cancerous cells and a margin of surrounding tissue using a colonoscope for suspected cancer cases. This is usually not a therapeutic alternative when the cancer diagnosis is already in place, but it can be “enough treatment” if a polyp with early stage cancer is removed during a colonoscopy, depending on the characteristics and size of the tumor.
Endoscopic Mucosal Resection (EMR):
This is a kind of local excision that allows the removal of larger polyps compared to traditional polypectomy.
Colectomy:
A colectomy involves removing all or part of the colon, either laparoscopically or through open surgery.
- Partial colectomy (Hemicolectomy):
- The surgeon removes completely the area containing the cancerous cells, including some healthy tissue around the tumor, reconnecting the new ends of the colon to eliminate gaps.
- Total colectomy: Less frequently performed, total colectomy involves removing the entire colon, reconnecting the small bowel to the rectum or the anal canal. This is typically reserved for cases with complications like inflammatory bowel disease or numerous polyps beyond cancer.
Proctectomy:
Proctectomy involves the removal of the rectum. There are different types of proctectomy procedures:
- Low Anterior Resection (LAR): This involves the removal of the rectum, connecting the remaining colon to the anus. It is commonly performed for rectal cancers.
- Abdominoperineal Resection (APR): APR involves the removal of the rectum, anus, and surrounding tissues. Following this procedure, the end of the colon is brought out as a colostomy.
- Pelvic exenteration: Pelvic exenteration is an extensive surgery that involves removing all the contents of the pelvic cavity, including the rectum, bladder, and reproductive organs.
HIPEC (Hyperthermic Intraperitoneal Chemotherapy):
HIPEC is a concentrated, heated chemotherapy delivered directly to the abdomen during surgery.
The procedure targets cancer cells in the abdominal area, which is particularly beneficial for colorectal cancer with abdominal tumors that haven’t spread to distant organs or lymph nodes.
Techniques used in colorectal cancer surgeries
A colorectal surgery can be performed using various techniques, each with its own advantages. Here are the primary methods:
- Open surgery: This traditional method involves a sizable abdominal incision, providing surgeons with direct access to and a clear view of the surgical site. While it allows for comprehensive procedures, it comes with longer recovery times, increased postoperative pain, and larger scars.
- Laparoscopic surgery: Minimally invasive technique using small incisions to insert a camera and specialized instruments. The benefits of this surgical technique include smaller scars, shorter hospital stays, and faster recovery.
- TAMIS (TransAnal Minimally Invasive Surgery): Ideal for smaller tumors or polyps, this anus-based approach eliminates external scarring. It allows for removing part of the rectal wall without impacting continence significantly.
Minimally invasive techniques are generally preferred due to the associated benefits of quicker recovery, reduced pain, and smaller incisions. However, open surgery may still be necessary in certain situations.
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