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How Colorectal Surgery Can Treat Bowel Cancer 

Colorectal surgery is commonly used to treat bowel cancer. 

The type of operation depends on the stage of the cancer and where it is in the colon. 

Colorectal surgery involves removing the area of diseased bowel, plus a section of normal bowel on either side of the tumour and the surrounding lymph nodes. 

Your care is led by your surgical consultant and discussed at multidisciplinary colorectal meetings. This team of multidisciplinary professionals specialises in bowel cancer, and discusses the benefits of treatment available for each patient individually.


 

Colorectal surgery of the diseased bowel either: 

  • Re-establishes normal continuity of the bowel by joining two healthy ends of bowel together (anastomosis). 
  • Uses abdominoperineal resection (APR) to completely remove the rectum and anal sphincter, resulting in a permanent colostomy. 

A stoma is a piece of bowel brought to the surface of the abdomen through which stools pass. If it is formed from the colon it is a colostomy. If it is from the last part of the small bowel it is called an ileostomy. 

If you have a stoma, The London Clinic stoma nurse will advise you before and after surgery. 

WHEN YOU COME INTO HOSPITAL FOR SURGERY 

You will be visited by a member of the medical team and the specialist colorectal/stoma nurse before your operation. You will also be seen by a physiotherapist who will assist you with breathing and leg exercises, which need to be done daily post-surgery.

A phlebotomist will also visit to take bloods from your arm. This gives the anaesthetist and surgeon a base line from which to work.

Bowel Cancer Surgery Operations

The type of operation depends on your individual circumstances. Your operation details will be discussed with you by your surgeon and specialist nurse. A written explanation about your sugery and operations will be given to you. 

Types of operations 

Your Operation 

While you are waiting to come in for your operation, it is important you try to prepare yourself physically. Try to eat a well-balanced diet; meat, fruit and vegetables. Take gentle exercise such as walking and get plenty of fresh air. If you smoke, stop before you come into hospital.

You will be contacted before your operation by the colorectal clinical nurse specialist to organise your admission.

When you return to the ward or our intensive care unit (ICU), you will be attached to several tubes which are put in while you anaesthetised. Your surgeon will decide whether it is appropriate for you to eat and drink initially.

You will have a drip in your arm or neck to give you fluids until you are eating and drinking again. You might also have: 

  • a catheter in your bladder to drain urine away. 
  • a tube down your nose (a nasogastric tube) to prevent nausea and vomiting
  • a drain tube in your abdomen to drain blood and fluid produced from the operation. 

The tubes will be removed over a period of days after the operation. 

It's normal to have pain for the first week or so. Straight after the surgery everything will be done to relieve any pain. You will be given either: 

  • analgesia (pain killers) either in the form of a PCSA (patient controlled analgesia) hand held pump which you control yourself or a continuous infusion of pain killers. 
  • You may also be given epidural anaesthetic via a fine tube in your back. 

The pain nurse specialist will visit you during your stay at The London Clinic. 

The anaesthetist will see you prior to your operation and discuss this with you. 

  • Haemorrhage
  • Sepsis
  • Intra-abdominal abscess formation
  • Anastomotic leakage
  • Bowel blockages
  • Wound infection
  • Others such as deep vein thrombosis
  • Pulmonary embolism
  • Chest infection

All of the above will be explained to you fully by your consultant, serious complications are not common.

The Post-Operative Period 

Making Progress

Each day your consultant will assess your abdomen to see if your bowel is now working again. When it does you can have sips of water to drink and then progress onto a cup of tea, soup and then a low fibre diet as tolerated. While you are not eating and drinking, fluid will be administered to you through a drip in your arm, hand or neck.

The most important sign of recovery of bowel function is the passing of wind, followed usually by a bowel action. There is considerable variation as to when this occurs, and it can take as long as a week before the bowel starts working. Each day your consultant will inform you of what you are allowed to eat and drink.

Your Wound

You will have stitches or staples (metal clips) to keep the wound together while it heals.

Occasionally the wound is glued. These will be removed between ten to fourteen days after the operation. The procedure is painless. Some people go home and return to the hospital to have them removed, others visit their GP or practice nurse.

Main switchboard: +44 (0) 207 935 4444

Treatment enquiries: +44 (0) 207 616 7693Consultant appointments: +44 (0) 207 616 7693 Prices for self funding patients: +44 (0) 203 219 3315Physiotherapy appointments: +44 (0) 207 616 7651X-ray and scan appointments: +44 (0) 207 616 7653Invoice and payment enquiries: +44 (0) 207 616 7708

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