Colorectal Cancer Surgery

Surgery is a common treatment option for colorectal cancer. The goal is to remove all or as much of the tumor as possible and prevent the cancer from spreading to other parts of the body. Surgery is often combined with other treatments, such as radiation therapy and chemotherapy, for heightened effectiveness.

The types of colorectal cancer surgery include:

Transanal endoscopic microsurgery (TEM)

TEM is a minimally invasive surgical technique that can be used to remove certain rectal polyps and small, early-stage rectal tumors. During the procedure, a surgeon will insert a specialized operating scope through the anus and guide it into the rectum. The scope will provide a magnified, high-definition view of the rectal wall, allowing the surgeon to precisely remove the polyp or tumor and a slim margin of surrounding healthy tissue.

Transanal endoscopic microsurgery offers several advantages over traditional open colorectal cancer surgery, including a lower risk of surgical complications, shorter hospital stay and faster recovery.

Partial colectomy

Typically performed using minimally invasive surgical techniques, such as laparoscopy and robotic surgery, a partial colectomy involves making several small incisions in the abdomen. The surgeon will then remove the cancerous portion of the colon along with a slim margin of surrounding healthy tissue.

To restore bowel function after a partial colectomy, the surgeon may perform an anastomosis to reconnect the remaining ends of the colon. Alternatively, if anastomosis is not possible, the surgeon may perform a colostomy to create an opening (stoma) in the abdomen to allow waste to pass out of the body.

Ileocolectomy

Also known as a right colectomy, an ileocolectomy involves surgically removing part of the last segment of the small intestine (ileum) and part of the adjacent first segment of the colon (cecum). If possible, the surgeon may perform the procedure using minimally invasive surgical techniques. An ileocolectomy may be followed by an anastomosis or colostomy.

Proctosigmoidectomy

Also known as a sigmoidectomy, a proctosigmoidectomy involves surgically removing the cancerous portion of the last segment of the colon (sigmoid colon) and the upper part of the rectum. If possible, the surgeon may perform the procedure using minimally invasive surgical techniques. A proctosigmoidectomy may be followed by an anastomosis or colostomy.

Total abdominal colectomy

The surgeon will remove the entire colon, including the cecum and rectum. If possible, the surgeon may perform the procedure using minimally invasive surgical techniques. A total abdominal colectomy may be followed by an anastomosis or colostomy.

Total proctocolectomy

The surgeon will remove the entire colon, rectum and possibly the anus. If possible, the surgeon may perform the procedure using minimally invasive surgical techniques. A total proctocolectomy may be followed by a permanent colostomy.

Abdominoperineal resection

The surgeon will remove the sigmoid colon, rectum and anus. If possible, the surgeon may perform the procedure using minimally invasive surgical techniques. An abdominoperineal resection may be followed by a permanent colostomy.

Hyperthermic (heated) intraperitoneal chemotherapy (HIPEC)

HIPEC is a two-step procedure that may be a treatment option for colorectal cancer that has spread to the peritoneal cavity, a space in the abdomen that contains vital organs, including the stomach, liver and intestines. After removing any visible tumors, a surgical oncologist will place a heated chemotherapy solution inside the abdomen, where it will circulate for approximately 90 minutes. By helping the chemo drugs penetrate the targeted tissues, the heat can heighten the effectiveness of the treatment. Once the HIPEC procedure is complete, the surgeon will drain the chemotherapy solution from the abdomen and close the incision.

A highly specialized procedure, hyperthermic (heated) intraperitoneal chemotherapy is typically performed by a team of experienced surgeons, oncologists and other medical specialists at a high-volume cancer center.

Services and features at Moffitt McKinley Hospital include:

• Surgery operating and recovery rooms
• Radiology/diagnostic imaging
• Pathology and laboratory
• Publix Pharmacy
• Ancillary clinical services
• Patient and Family Center
• Café and cafeteria
• Gift shop

Does colorectal cancer surgery mean I will need a colostomy bag?

Not necessarily. The need for a colostomy bag after colorectal cancer surgery depends on several factors, including the location and extent of the tumor, the type of surgery performed and the patient’s overall health. In some cases, a surgeon can remove the tumor and reconnect the remaining portions of the colon and rectum without the need for a colostomy. However, in other cases, especially if the tumor is situated low in the rectum or if there are complications during surgery, a colostomy may be necessary to divert stool temporarily or permanently.

If a colostomy is performed, waste will be collected in a small pouch connected to the colon via a stoma. A specially trained nurse (ostomy nurse) can provide detailed instructions on how to care for the stoma and colostomy bag. In some cases, a colostomy can be reversed if the ends of the intestines can be surgically reattached after healing.

If a colostomy was not performed, most patients gradually regain their normal bowel function and have a normal bowel movement within 4-5 days. During recovery, some patients experience:

• More urgent bowel movements
• More frequent bowel movements
• Bowel incontinence
• Diarrhea or constipation
• Fragmented stool (stool passed in small, intermittent episodes)
• Bowel or rectal pain

Most of these side effects are temporary and usually resolve within a few weeks.

Benefit from world-class care at Moffitt Cancer Center

The board-certified, fellowship-trained surgeons in Moffitt’s Gastrointestinal Oncology Program are skilled and experienced in performing the latest surgical techniques, including laparoscopic colon resections, anal sphincter-preserving surgeries and HIPEC. Our multispecialty team thoroughly reviews each patient’s case, evaluating the location and stage of the tumor and other unique factors to develop an individualized treatment plan.

If you would like to learn more about colorectal cancer surgery, you can request an appointment with a specialist in our Gastrointestinal Oncology Program by calling 1-888-663-3488 or submitting a new patient registration form online. We do not require referrals.