Bowel cancer Surgery

Mr McArthur, in conjunction with other team members (oncologists, specialist nurses, radiologists and histopathologists) cares for patients with bowel cancer and other diseases of the bowel.

What does surgery for bowel cancer involve?

Unless bowel cancer is caught at a very early stage and can be treated by local excision, either at the time of colonoscopy or using a special operating microscope, most patients with the condition require surgery to offer a chance of cure. Surgery aims to remove the part of the bowel that contains the cancer, together with some of the surrounding tissue that contains the lymph glands that drain the affected part of bowel. Lymph glands are small bean-shaped organs that are part of the immune system; they are taken out because cancer tends to spread to the lymph nodes. Analysis of the nodes under the microscope enables us to ensure that the cancer has been completely removed; if there is evidence of spread to lymph glands, then chemotherapy may be recommended once you have recovered from surgery. Your surgeon will explain the benefits and risks of having bowel surgery, and will discuss any alternatives to the procedure.

About the operation

Most surgery for bowel cancer can now be performed laparoscopically (keyhole surgery), although occasionally a more traditional open operation is necessary. Laparoscopic surgery confers the advantages of a quicker recovery, less post-operative pain and reduced wound infections, whilst having equivalent effectiveness at treating the cancer. The exact operation performed will be determined by the location of the cancer. The colon can be considered as a long tube. Bowel surgery usually involves removing the section of tube affected by cancer or other disease and joining the two healthy ends together with stitches or staples. Your surgeon will discuss with you all aspects involved in the operation to be undertaken.

Colostomies and ileostomies

If the two ends of the bowel cannot be re-joined, you may need a colostomy or ileostomy. This is when one end of the bowel is brought through an opening in the skin (called a stoma). Waste can then pass from the intestine into a self-adhesive appliance [or bag]. The bag is worn over the stoma and lies against the abdomen. Colostomies and ileostomies may be temporary, allowing the bowel time to heal after an operation. Once healed, the stoma may be reversed. However, in some cases a permanent colostomy or ileostomy may be necessary. Your surgeon will discuss colostomies, ileostomies and stomas with you before the operation. Sometimes it isn’t possible for your surgeon to tell exactly what is needed until the operation is under way. Major intestinal surgery is commonly performed and generally safe; however, all surgery carries an element of risk and your surgeon will explain the specific risks of the bowel surgery with you.