Surgery for Rectal Cancer

Physicians utilize the following diagnostic methods to determine tumor size, its location and metastatic spread:

• PET-CT scan;
• MRI;
• biopsy;
• ultrasound;
• palpation;
• anoscopy.
• physical exam;

There are following indications for rectal tumor surgery:

• the tumor is operable;
• the procedure doesn’t pose any risks to patient’s health;
• cancer is localized in the rectum;

Contraindications for the operation include:

• poor overall health condition of a patient;
• cancer has spread to other organs;
• severe infections (HIV, hepatitis);
• blood pathologies that may affect clotting (anemia).

Surgery is the main and the most effective tumor treatment option. The type of preferred operation depends on tumor localization and its size.

• Local resection surgery is performed for patients with early stages of cancer. The tumor and margin tissues around it are removed. This operation is performed without making incisions - through patient’s anal cavity. The procedure doesn’t put patient’s body under much stress and preserves all its functions. Postoperative recovery in a hospital takes up to 1 week. After the operation, physicians study the margin tissue to determine whether cancer was removed completely.
• Abdominoperineal resection also referred to as APR for rectal cancer. Physicians perform this operation for patients with late stages of the disease, when other management options are ineffective. During the procedure, a part of patient’s colon, rectum, and anus are removed. In some cases surgeons also remove adjacent lymph nodes while performing APR for rectal cancer to prevent cancer spreading. This rectal cancer surgery is complex, performed under general anesthesia. Surgeons make an incision in patient’s abdomen to access cancerous focus points. Then surgeons make an opening in the stomach and connect the end of the bowel to it. It is called a stoma. A special bag is attached to the opening for stool collection. This way patients will be able to empty their stomachs.
• Low anterior resection, also known as LAR rectal cancer surgery. During this operation, physicians remove tumors in the upper part of the rectum. It is applied for stage 1 cancer, rarer - for stages 2-3. During the intervention, a part of the rectum containing tumor is removed. The colon is then sewn to the remaining part of the rectum. Patients who don’t require colostomy after the procedure may need ileostomy. This manipulation has the same intent as colostomy but is completely reversible. Patients need it for a period of up to 8 weeks while the rectum recovers after LAR rectal cancer surgery. The operation is performed by a team of surgeons in 2-3 hours. A patient stays under general anesthesia. Hospitalization lasts for up to 7 days, rehabilitation takes 4-7 weeks.