Colorectal Surgery

Last updated date: 18-Aug-2023

Originally Written in English

Colorectal Surgery: Treatment Procedures 

The colon, anus, and rectum usually facilitate various body functions. It includes digestion, reabsorbing fluids, processing the waste products, and eliminating them. However, the organs are sometimes susceptible to a range of acute and chronic health conditions. 

Depending on the disease and severity, doctors can administer treatment forms like medications and therapies. However, chronic and life-threatening conditions are usually addressed through colorectal surgery. This helps treat, repair, and restore the normal functions of the colon, rectum, and anus. 

 

The Objective of Colorectal Surgery

Colorectal or colon surgery is a medical branch concerned with health conditions affecting the colon, anus, and rectum. It aims at surgically treating and managing acute to chronic and complex diseases and injuries of these parts.  

Colorectal surgeons often conduct the procedure to treat and correct various conditions. Depending on the type of the disease, the surgery can have varying objectives. For instance, the aim of the surgery for patients diagnosed with early-stage cancer is to remove the cancerous cells. 

Sometimes, the surgeon may be required to cut the colon and perform a colostomy, creating a stoma. This is mostly done when cancer has spread to other parts or blocks the large intestine. A surgery also enables the body to excrete stool regardless of the blockage. However, this won’t completely remove the cancerous cells; hence other treatment forms like chemotherapy and radiation therapies are essential. 

 

Types of Colorectal Surgery

Depending on the health condition and the affected part, surgeons can perform several colorectal surgery types, including; 

  • Colectomy 

This is a surgical procedure to remove a section or the entire large intestine. It comprises the following; 

Polypectomy: Uses a colonoscope to remove benign polyps from the rectum or the colon. Surgeons perform polypectomy by inserting a colonoscope into the rectum and passing it through a wire loop to remove the polyps. 

Polypectomy

Segmental colectomy: This involves creating an incision in the center of the abdomen that overlies the part of the bowel affected by the disease. Through the incision, the affected part is removed. To treat cancer, a wider part of the bowel is removed, including the lymph nodes. After that, the surgeon joins the bowel's ends to allow healing and restore the normal functions. 

Total colectomy: This involves total removal of the whole colon to treat conditions, including ulcerative colitis. The end of the small bowel is then joined to the rectum. A new pouch is also made by folding the small bowel and stapling it back. The new pouch is then connected down the anus to facilitation the normal functions. 

  • Resection 

This is a surgical procedure that aims at removing a section or the entire diseased organ or tissue. Resection comprises the following; 

Small bowel resection: This is a surgical procedure to remove cancer, polyps, benign tumors, ulcers, and Crohn’s disease. It involves removing small parts or the small intestines' diseased sections and sewing the remaining healthy parts together. 

Rectal resection: A surgery to treat and repair distal rectal cancer. It involves removing the rectum anus and a section of the sigmoid colon. This is to add to the attending lymph nodes and blood vessels. After that, the end of the colon is connected to the opening created on the abdominal wall. 

Low anterior resection: During this procedure, the surgeon removes a rectum section and reconnects the remaining parts (anastomoses). This procedure involves dissecting deep into the pelvis. Usually, anastomoses done at the deep level increases the risk of fluid leakage. However, the doctor can make an ostomy above to help prevent bowel movement pressure. 

Laparoscopic colon resection: During this procedure, the surgeon uses several methods to help treat and manage colorectal cancer. The procedure also uses a laparoscope; illuminated tube equipment passed through the small incision made on the abdomen. It helps view and analyzes the abdominal organs and removes malignant tissues and lymph nodes. 

  • Endoscopic surgery

Endoscopic surgery uses a scope, a thin, flexible tube attached to a camera, and a light source at the tip. This enables the surgeon to visualize the colon's inner part and conduct surgery without necessarily creating major incisions. This makes the entire procedure easier. It’s also characterized by less discomfort and pain and shorter recovery time. Endoscopic surgery can as well be used for diagnosis purposes. 

  • Colostomy 

This surgical procedure involves creating a hole in the abdominal wall and pulling one of the colon ends via the opening. This helps treat several health conditions of the rectum, colon, and anus. 

The colostomy procedure modifies how the body gets rid of waste products and stool. Through the incision, one end of the colon is diverted in the abdominal wall to form a stoma. This is an opening on the skin that is attached to a pouch to collect the fecal matter. Colostomy procedure can either be permanent or temporary. 

  • Inflammatory bowel disease (IBD) surgery 

Inflammatory bowel disease comprises Crohn’s disease and ulcerative colitis. These conditions result in flare-ups of severe intestinal pain that can require immediate medical attention. A surgical procedure may be performed to treat these conditions, hence preventing the risk of developing colon cancer. 

  • Rectopexy

Rectopexy is a surgical procedure to treat and repair rectal prolapsed. This is a condition where the rectum protrudes through the anus. It aims at restoring the rectum to its normal location in the pelvis. 

Before the procedure, the surgeon can first recommend a bowel-cleansing regimen. This is to free the digestive system from the stool and prepare for the procedure. The procedure involves:

  • Creating an incision along the abdomen.
  • Separating the rectum from other tissues.
  • Lifting the rectum and suturing it to the sacrum.

The surgery can sometimes be done alongside anterior resection surgery to help remove a section of the colon. 

  • Internal sphincterotomy 

This is a procedure to treat anal fissures, small tears that occur in the mucous lining of the rectum. Although fissures can heal on their own or through other treatment forms, internal sphincterotomy is essential if the condition persists. 

This surgery aims to stretch out or cut the internal sphincter. This temporarily weakens the muscles, hence facilitating healing. The internal sphincter is the body muscle that usually opens and closes to enable the stool to pass through from the body. 

During this procedure, the surgeons can first administer local anesthesia to help numb the whole part. Alternatively, they can use sphincter anesthesia to numb the whole lower body or general anesthesia. A small incision is then made on the internal anal sphincter to help minimize pressure on the muscles. However, this procedure doesn’t close the fissure; instead, it has to heal independently. 

  • Hemorrhoidectomy 

Surgeons often use this technique to treat hemorrhoids, especially if other treatment forms, including medication and lifestyle changes, are unsuccessful. It involves creating an incision around the anus to help with the removal of hemorrhoids. 

 

Common Colorectal Conditions

 Colorectal Conditions

The minor colorectal diseases can be addressed through simple, non-invasive methods such as medications and therapies. However, the chronic and complex conditions might require a surgical procedure to treat and prevent more complications. Some of these colorectal conditions include; 

  • Anal fissures 
  • Cancer of the small intestine, rectal, and colon
  • Diverticulitis 
  • Fistula 
  • Gastrointestinal cancer syndrome 
  • Hemorrhoids 
  • Hereditary polyposis  
  • Inflammatory bowel diseases such as ulcerative colitis and Crohn’s disease
  • Irritable bowel syndrome 
  • Polyps 
  • Rectal prolapse

 

Risks of Colorectal Surgery

The risks and complications that might arise during and after the colorectal surgery procedures include; 

Changes in the bowel: Most people experience changes in the bladder and bowel functions. Although it can improve over time, it might take an extended duration for some people. In men, erection disorder might arise following surgery. 

Fatigue: After the surgery, patients often experience extreme fatigue. Although doctors recommend being active and doing simple exercises, some people find this difficult. Instead, they get tired easily can even spend their day resting. 

Severe pain: Depending on the type of colorectal surgery, you are likely to experience chronic pain and soreness during the recovery period. 

Infection: Sometimes, infections of the surgical site can occur, increasing the chances of developing chronic complications. This can also interfere with the healing process. 

Severe bleeding: Sometimes, the surgical opening or incisions can bleeding excessively even after the surgery, hence interfering with the recovery process.

Formation of blood clots: Blood clots can sometimes develop in the surgical site. This interferes with normal blood circulation and can result in other severe complications. 

Anesthesia reaction: Some patients react negatively to anesthesia, making them experience nausea and vomiting. 

Damage to other body parts: During the surgery, healthy organs, tissues, or blood vessels can be accidentally damaged, causing more complications. 

 

Conclusion 

Colorectal surgery is a type of medical surgical procedures. It aims at treating and managing conditions of the colon, rectum, and anus. Surgeons perform most of the colorectal procedures through a small incision made on the abdomen. Also, through the incision, surgeons can treat cancer by removing the affected parts. 

CloudHospital Specializes in colorectal surgery. It also works with surgeons who offer comprehensive diagnosis and treatment of a wide range of colorectal conditions. Moreover, they work with other specialists from different fields to give you innovative and supportive care.