Procedure of the surgery
Surgery for colorectal cancer can be performed with different approaches. The first option is open surgery, in which a large skin incision is made and the abdomen is kept open with hooks during surgery. The second approach is laparoscopic.
In this type of surgery, working channels are inserted through several small skin incisions. Through one of these channels a camera is inserted, through the other channels the surgeon can operate with special tools. The advantage of this method is that the wounds are much smaller, which brings advantages in wound healing.
Which method is chosen depends on the location and feasibility of the laparoscopic surgery. The basic principle of the operation is the complete removal of the affected intestinal segment. Care must be taken to maintain a certain distance from the tumor to ensure that no tumor tissue remains in the body.
During the operation, the other abdominal organs, such as the liver, are also scanned for suspicious lumps. In the course of the operation, lymph nodes are removed, which are then examined for cancer cells. If these are free of cancer cells, it can be assumed that scattering has not yet taken place.
After removal of the affected section of the intestine, either a direct connection between the two ends, a so-called anastomosis, is made or an artificial intestinal outlet (anus praeter) must be created. Under certain circumstances, this may have to remain in place permanently. If it is possible to restore the intestinal passage, this artificial outlet can also be relocated back after a certain period of time.
An artificial bowel outlet, also known as a stoma or anus praeter, may become necessary after bowel surgery. For this purpose, the blind end of the intestine, which lies in the direction of the stomach, is connected to an opening in the abdominal skin. The other end of the intestine, which is in the direction of the anus, is closed.
This ensures that excretions can pass through a safe route to the outside. The first choice for intestinal surgery is a direct connection between the two sections of the intestine surrounding the removed section. However, if this is not possible for various reasons, the artificial bowel outlet must be selected.If there are no wound healing problems and the colon cancer could be completely removed, the artificial bowel outlet can be closed again after a certain period of time and the two bowel sections can be connected. The retransfer requires another operation in which the connection with the abdominal skin is separated again and the two blind intestinal sections are connected. However, if an intestinal passage cannot be restored after the operation, the stoma may have to remain forever.
