Surgery for Colon Cancer

The large intestine is also called the colon. This is the final portion of the digestive tract. The function of the colon is to remove water from the stool. The most common reasons to remove all or part of the colon are cancer of the colon, diverticulitis, or polyps.

If only a portion of the large intestine is removed, a person may not notice any difference in digestion or bowel movements. If an extensive amount is removed the stools may be somewhat loose. It is possible to live with the entire colon and rectum removed. However, in that situation it is necessary to have the stool come out into a bag on the front of the belly. This is called a colostomy.

Cancer of the colon is one of the most common types of cancer in the United States. Its presenting signs or symptoms are often constipation or blood in the stool. If it is detected early and treated there is a good chance of cure. The treatment is usually surgical removal of the cancer along with a few inches of normal bowel on either side.

This is considered a major operation and must be done in the hospital under a general anesthetic. It is necessary that the bowels be cleaned out before colon surgery, either at home the day before the surgery, or in the hospital.

The operation can take anywhere from thirty minutes to several hours. An incision is made on the belly and the abdomen is opened and explored. The appropriate section of colon is removed and the ends sutured or stapled back together.

Whenever surgeons operate on the colon there is a possibility that a colostomy might be needed on a temporary or permanent basis. If there is a high probability that a patient will need a colostomy the surgeon will have discussed the possibility beforehand. However, there are situations where unpredicted findings at surgery make an unplanned colostomy necessary. This is only done if it is absolutely necessary to get a patient through the operation safely.

After the operation the portion of colon that has been removed will be sent to the pathology laboratory for microscopic examination. The pathologist will carefully look at the colon and the lymph glands next to the colon, and will tell us the exact type and extent of the tumor. It takes 2-3 days for us to get this information.

The three major factors that are used to determine the stage of colon cancer are:
-How deep the cancer penetrated the wall of the colon.
-Whether the lymph glands next to the colon are involved.
-Whether the cancer has spread elsewhere in the body.

If the lymph glands are involved with cancer, and a patient is in good general health, chemotherapy is recommended postoperatively. Even if the lymph glands are not involved with cancer chemotherapy may be recommended. When chemotherapy is given after a potentially curative operation it is called adjuvant (extra) chemotherapy. This type of treatment is given by a medical cancer specialist, called an oncologist. Once you have recovered from the surgery, your surgeon will arrange for you to see an oncologist to discuss this.