Surgical Procedures for Colorectal Cancer

Authors:

Michelle Badash, MS

Publication Type:

Condition InDepth

Removal of the cancer is the most common treatment if it has not spread far. The goal is to remove as much of the cancer as possible while keeping as much colon and/or rectum as is safe. It is common to combine surgery with radiation therapy and/or chemotherapy. It will increase the chance that all the cancer is removed.

Surgery may need to be done on the colon, rectum, or both.

Colon Surgery

Rectal Surgery

Rectal surgery is more complex. This surgery involves other nearby tissue, such as urinary system tissue.

Surgery for Metastatic Colorectal Cancer

Metastatic colorectal cancer cannot be cured with surgery. Surgery may help to prolong life by treating tumors in other parts of the body. It is most often used for cancer that has spread to the liver, but it can also be used on other tumor sites. Options include:

Depression is a common symptom of colorectal cancer. During a hospital stay, psychotherapy may be part of the treatment plan.

Polypectomy and Local Excision

A scope is placed through the anus and rectum, up into the colon. The scope allows the doctor to see inside the colon. Tools are passed through the scope to remove polyps and/or early stage cancer. It cannot be used for cancer that has invaded deep into the colon wall. Tissue samples of the colon will also be taken for biopsy.

Polypectomy and Local Excision

Partial Colectomy

An area of the colon is removed during a partial colectomy. It may be done to remove cancer that is deep in colon wall. The tumor, health colon around it, and nearby lymph node may all be removed. The healthy parts of the colon (and rectum) can often be reconnected. That means the colon and anus can continue to work.

Laparoscopic-assisted Colectomy

A laparoscopic surgery uses small incisions to access the area. This can lead to faster recovery than open surgery. This surgery will also remove the tumor, healthy tissue around it, and nearby lymph nodes. All tools will be passed through small incisions in the belly.

Total Colectomy

A total colectomy is the removal of the entire colon. The end of the small intestine may then be connected to the rectum. This will let stool pass through the rectum. Sometimes, a pouch may be made at the end of the small intestine. It will be used to make a colostomy.

Surgical Resection of a Colorectal Tumor Mass.

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Colostomy

A colostomy may be needed if the intestine cannot be reattached to the rectum. A colostomy is a surgical opening through the wall of the belly. The small intestine or remaining colon will be attached to the opening. Waste can then pass through the opening into a pouch. A colostomy may be temporary and just used while the intestines recover. It may also be permanent if too much intestine was removed or the rectum was damaged.

References

Benson AP, Venook AB, Cederquist L, et al. Colon Cancer. Version 2.2017. In: National Comprehensive Cancer Network (NCCN) Clinical Practice Guidelines in Oncology (NCCN Guidelines). NCCN 2017 Mar from NCCN website.
Colon cancer treatment option overview. National Cancer Institute website. Available at: https://www.cancer.gov/types/colorectal/patient/colon-treatment-pdq#section/_135. Updated January 30, 2020. Accessed February 27, 2020.
Colorectal cancer. American Cancer Society website. Available at: http://www.cancer.org/acs/groups/cid/documents/webcontent/003096-pdf.pdf. Accessed February 27, 2020.
Colorectal cancer. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/colorectal-cancer. Updated January 22, 2020. Accessed February 27, 2020.
Glynne-Jones R, Wyrwicz L, Tiret E, et al. Rectal cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2017 Jul 1;28.

Contributors

Mohei Abouzied, MD

Last Updated:

2019-12-01

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

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