In the majority of diagnosed cases, the treatment of choice for colorectal cancer is surgical, with removal of the tumor. Only in more advanced cases (with metastasis, i.e. involvement of other organs) or in certain cases of cancer located in the rectum, other treatments such as chemotherapy or radiotherapy are initially indicated, aimed at making surgical resection of the tumor possible at a later date.
The aim of surgical treatment is the complete removal of the segment of colon or rectum where the tumor is located, including the surrounding tissues and lymph nodes through which the cancer may spread, and sewing the intestine back together to reconstruct normal intestinal transit.
After analysis of the tumor, in the most initial cases, surgery is sufficient; in those cases in which the tumor is more advanced, surgical treatment must be complemented with postoperative chemotherapy or radiotherapy.
Types of surgery
Depending on the location of the cancer (right colon, transverse, left or rectum) the surgery to be performed receives different names: segmental resection, right hemicolectomy, left hemicolectomy or resection of the rectum, as well as the reconstruction or anastomosis (stitching) that is performed: ileo-colic, colo-colic or colo-rectal anastomosis.
Nowadays, thanks to the increasingly frequent early diagnosis, patients are operated on at earlier stages and on an elective or programmed basis (which represents a better preoperative preparation of both the patient and the bowel), making it possible to suture the bowel in the majority of cases.
In those cases of urgent surgery (due to occlusion or perforation of the colon) where the local conditions of the tumor or the general conditions of the patient do not allow it, the practice of a colostomy (the so-called “anus contra natura”) is required, which in most cases will be temporary. Once the patient has recovered and after a reasonable period of time, a second operation can be performed in which the intestinal transit will be reconstructed.
Laparoscopic surgery
Classically, surgery for colon and rectal cancer required large incisions in the abdomen to remove the tumor. For years now, in specialized centers, the laparoscopic technique has also been used in colorectal surgery, making it possible to perform cancer resection with the same oncological guarantees as open or “conventional” surgery and providing the benefits already demonstrated in other fields of laparoscopic surgery: smaller and more aesthetic incisions, less postoperative pain, faster recovery and an early return to normal activity.
Advice after colon and rectal surgery
Naturally, after a colon or rectal resection, the intestinal habit or functioning of the patients presents some alteration: usually the consistency of the stool decreases and the number of bowel movements per day increases. A sufficient intake of liquids and fiber, associated with a more or less astringent diet and free of intestinal irritants such as alcohol, coffee, spices and hot spices is usually enough to alleviate the symptoms, although sometimes it may be necessary to associate some medication.