Colorectal surgery
Surgery is one of several methods used to treat colorectal cancer. It can be used to make the diagnosis, prevent colorectal cancer, remove cancer and treat complications. There are several types of surgery that can be offered.
Preparing for surgery
Your surgeon will make sure that you are fit to go to theatre. Sometimes you will need a bowel cleanse in preparation for surgery. This is usually needed before surgery to remove your rectum.
The operation
Colorectal cancer will often require removal of a part of the colon or rectum along with associated lymph nodes. This is done to see how far-advanced the cancer is; a pathologist will check the size of the tumour and whether it may have spread to lymph nodes. Sometimes, a colostomy (opening through the abdomen for faeces) is required to allow the bowel to heal. This might be reversed at a later stage but sometimes needs to be permanent.
Colonoscopy
If the cancer is tiny enough, it might be able to be removed by using a colonoscope. Bigger cancers aren’t adequately removed this way and should have surgery. However, bigger, benign growths can safely be removed; this will mean that they won’t become cancer later.
Transrectal surgery
Small cancers and polyps that are close to the anus can be removed by operating through the anus. As the rectum has no feeling, this is a mostly painless operation.
Open surgery
The colon and rectum can be removed by making a cut into the abdomen. This requires careful management of pain afterwards. Sometimes, the bowels can stop working and it may take a few days before you’re able to eat. It’s important to move around as early as possible after surgery.
Laparoscopic surgery
Performed through keyhole surgery; it’s the same as open surgery except the cuts are smaller, pain is usually less, and the bowels work sooner so you’re able to eat sooner.
Robotic surgery
Surgery performed using the robot causes a bit less pain and blood loss than other surgery types. Because this technology uses high-resolution magnification, it can be very precise.
Post-operative
Your surgeon will help manage pain. Surgery can sometimes result in complications (infection and bleeding).These are managed using medication, drains or another operation. Most of the time, you can go home after four to six days with medication to treat the pain and a few extra dressings for the wounds. At home, it’s important that you remain moderately active, eat as your surgeon advised and follow-up as necessary.
Dr Daniel Surridge is a subspecialist colorectal and robotic surgeon in Gauteng. He heads up the Joburg Colorectal Unit at Netcare Milpark Hospital. He was formerly the head of colorectal surgery at Chris Hani Baragwanath Academic Hospital which he ran for over seven years, and he has travelled extensively to acquire advanced skills and approaches to colorectal surgery.
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