Colorectal cancer surgery should generally be performed as soon as possible after diagnosis. However, it is very important to carry out a correct preoperative and extension study before considering the intervention, because sometimes, depending on the local stage or the distance of the tumor, this treatment scheme can be altered.
This can occur, for example, in cases of locally advanced rectal cancer, in which neoadjuvant therapy is usually performed, that is, preoperatively, with associated radiotherapy and/or chemotherapy.
Also in cases of disease spread to other organs, it is sometimes necessary to perform treatment with chemotherapy, and subsequently evaluate the intervention of colorectal carcinoma. In any case, an early assessment by the surgeon and the team is important to decide the best treatment strategy for each case.
Before colorectal cancer surgery
Classically, prior to surgery for any colorectal pathology, a complete colon preparation should be performed, i.e., absolute diet and the intake of different cathartic solutions (laxatives) to cleanse the colon, as is done prior to colonoscopy, for example.
However, lately the trend in colon surgery is moving away from this preparation towards less aggressive schemes, without performing complete colon preparation, thus avoiding electrolyte disorders and preoperative dehydration, as proposed in the most modern multimodal rehabilitation protocols or Fast-Track protocols.
Main surgical techniques in colorectal cancer
The techniques to be used will depend mainly on the type and location of the tumor, and on the characteristics of the patient, i.e., the technique must be adapted to each patient and not make the mistake of using the same surgery for everyone, since, obviously, each patient is different.
What is evident is that, if there is no contraindication for its use, minimally invasive surgery (either conventional laparoscopy or single port approach) presents the same results at the oncological level (control of the tumor disease) but with better results in terms of recovery, with less pain, earlier discharge, and fewer complications of the surgical wound, such as infection or hernias at this level, so it should be considered as the choice to be taken whenever possible.
Colorectal cancer surgery: what does it consist of?
The intervention basically consists of performing a resection of the colon or rectum, including the tumor, with adequate safety margins, and also performing a lymph node emptying (of the lymphatic tissue where the tumor drains) to achieve a correct oncological surgery, as well as to make a correct definitive diagnosis in order to decide whether it is necessary to associate any other treatment.
Postoperative period after colorectal cancer surgery
The postoperative period will depend on multiple factors, but basically the aim is to reintroduce feeding within 24-48 hours, as well as early ambulation (getting up and walking). The length of hospitalization varies according to the type of surgery, but can vary between four and seven days depending on the intervention and whether or not complications appear, which can alter the postoperative period.
It should be noted that laparoscopic surgery has contributed to shortening both hospitalization and recovery time, but, as already mentioned, this will depend on multiple factors, whether they depend on the patient or on the surgical technique.