A colectomy is a surgery to remove all or part of the colon. All the lymph nodes which drain the affected area are also removed. This is called a radical colectomy.
- If only part of the colon is removed, it's called a hemicolectomy, partial colectomy, or segmental resection. The remaining sections of the colon are then reattached. This is usually done by means of a surgical stapler.
- If the entire colon is removed, it's called a total colectomy.
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 or robotic-assisted colectomy: The surgery is done through smaller incisions and special tools. Because the incisions are smaller in a laparoscopic-assisted or robotic 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... We routinely perform laparoscopic and robotic colectomies. However, it may not be the best approach for large or bulky tumors. it is important to remember that the main aim has to be complete and radical removal of the tumor safely rather than avoiding a scar.
Surgery is usually the main treatment for rectal cancer. Radiation and chemotherapy are often given before the surgery.
Transanal excision (TAE)
This surgery can be used to remove some early-stage I rectal cancers that are relatively small and not too far from the anus.
Low anterior resection (LAR)
Some rectal cancers in the upper or mid part of the rectum can be removed by low anterior resection (LAR). In this operation, the part of the rectum containing the tumor is removed along with the draining lymph nodes The rejoining of the colon with the rectum is done by means of a stapled device.
Sometimes, a temporary stoma is given to divert the stool and that allows the joint to heal well. This stoma is reversed later by a surgical procedure.
Abdominoperineal resection (APR)
This operation is needed if the cancer is growing into the sphincter muscle (the muscle that keeps the anus closed and prevents stool leakage)
Here, the anus is removed along with the rectum, and a permanent colostomy is needed (the end of the colon is connected to a hole in the skin over the abdomen) to allow stool to pass.
All types of surgeries for rectal cancers can be performed by either laparoscopic, robotic, or open approaches depending on various factors.
What types of screenings you have and how often you get them will depend on the type and stage of cancer you had and the treatments you got. You'll probably need check-ups three to four times a year during the first 2 or 3 years after treatment and one or two times a year after that. These might include:
- A physical exam
- Colonoscopy, usually 6 months to 1 year after surgery. Your doctor can tell you how often you'll need one.
- CT scans of your chest, abdomen, and possibly pelvis every 6 to 12 months for the first 3 years
- CEA (carcinoembryonic antigen) blood test every 3 to 6 months for 5 years. High levels of CEA protein in the blood may mean cancer cells have spread.
Colorectal Cancer Prevention
- healthy tobacco-free lifestyle
- exercise and healthy lifestyle (The American Cancer Society says adults should get 150 minutes of moderate-intensity or 75 minutes of high-intensity exercise (or a combination of these) each week.
- a low-fat, high-fiber diet that includes at least 2 1/2 cups of fruits and vegetables each day
- Cut back on red meat and other high-fat foods
- Avoid overcooking or barbecuing meats and fish.
- Screening for colorectal cancer
- Genetic counseling and testing