Bowel Resection for Colorectal Cancer

Bowel Resection for Colorectal Cancer

Surgery Overview

Resection is another name for any operation that removes tissue or part of an organ. Bowel resection for colorectal cancer, also called partial colectomy, removes the tumor. To make sure that only healthy tissue is left, the doctor removes a small amount of colon or rectum tissue on both sides of the tumor.

The goal of bowel resection is to take out the part of the colon or rectum where the cancer is. Nearby lymph nodes are taken out and tested for cancer. Then healthy parts of the colon or rectum are sewn back together. Bowel resection is done either by opening the abdomen (open resection) or by laparoscopy.

How It Is Done

Anatomy of the colon and rectum

The colon and rectum and where they are in the body
slide 1 of 5
    
slide 1 of 5, Anatomy of the colon and rectum,

The colon and rectum are the last parts of the bowel (intestine). The bowel extends from the opening where food leaves the stomach to the opening where feces leave the body (anus). The bowel helps to process food, absorb nutrients and water, and get rid of waste.

Colon cancer site

Cancer in the wall of the descending colon
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slide 2 of 5, Colon cancer site,

Cancer is shown in a section of the descending colon.

Bowel section removed

Section of colon removed
slide 3 of 5
    
slide 3 of 5, Bowel section removed,

Resection is another name for any operation that removes tissue or part of an organ. Bowel resection, also called partial colectomy, for colorectal cancer removes the tumor and part of the colon or rectum around the tumor. Both ends of the bowel section being removed are stapled and cut. Nearby lymph nodes, lymph drainage channels, and blood vessels are also removed.

Bowel reattached

Ways the cut ends of the colon may be reattached
slide 4 of 5
    
slide 4 of 5, Bowel reattached,

The remaining ends of the bowel are reattached, either end-to-end, side-to-side, or side-to-end.

Surgery scars

Comparison of laparoscopic surgery scars and open surgery scar
slide 5 of 5
    
slide 5 of 5, Surgery scars,

If you have laparoscopic surgery, you will have 3 to 6 small scars. An example is in the picture on the left. Your surgeon may make 1 or 2 of the small openings a little bigger to allow space to complete the procedure. If so, those scars will be a little longer than the others. If you have an open resection, you will have one long scar. An example is in the picture on the right.

What To Expect

Bowel resection requires general anesthesia. You may stay in the hospital for 4 to 7 days or as long as 2 weeks after surgery.

Sometimes the two parts of the colon or rectum can't be reattached, so the surgeon performs a colostomy. This creates an opening, called a stoma, on the outside of the body for the stool, or feces, to pass through into a colostomy bag. Usually the colostomy is temporary, until the colon or rectum heals. If the lower part of the rectum has been removed, the colostomy is permanent.

When the two-stage operation is done, the time between operations is usually 6 to 12 weeks.

The recovery time after a one-stage operation or after the final operation of a two-stage surgery is usually 6 to 8 weeks.

Why It Is Done

In early-stage cancer, surgery is done to remove as much cancer as possible to give the greatest chance of a cure.

In cases of advanced colorectal cancer that has spread (metastasized) to other parts of the body, bowel resection is often done to remove tumors that are blocking the intestine or causing bleeding.

How Well It Works

Bowel resection is the most successful treatment for invasive colorectal cancer.footnote 1

Up to 12 out of 100 people who have surgery for diverticulitis develop diverticulitis again.footnote 2 But another surgery is usually not needed.

Some people who have two-stage surgeries may not have the second part of the surgery to reattach the intestine and repair the colostomy. This is often because the intestine does not heal well enough to be rejoined.footnote 3

Surgery is not a cure for Crohn's disease. When surgery for Crohn's is needed, as little of the intestine as possible is removed to keep the intestines working normally. The disease tends to return to other areas of the intestines after surgery. In children, surgery may improve well-being and quality of life and restore normal growth and sexual development.

Risks

All surgeries have some risks of infection, severe bleeding, or complications from general anesthesia.

Possible problems after a bowel resection include:

  • Scar tissue (adhesions).
  • A leak between the joined sections of the colon.
  • Injury to the bladder, ureters, or blood vessels.

References

Citations

  1. Eng C (2011). Colorectal cancer. In EG Nabel, ed., ACP Medicine, section 12, chap. 5. Hamilton, ON: BC Decker.
  2. Davis BR, Matthews JB (2006). Diverticular disease of the colon. In M Wolfe et al., eds., Therapy of Digestive Disorders, 2nd ed., pp. 855–859. Philadelphia: Saunders Elsevier.
  3. Harford WV (2010). Diverticulosis, diverticulitis, and appendicitis. In EG Nabel, ed., ACP Medicine, section 4, chap. 12. Hamilton, ON: BC Decker.

Credits

Current as of: December 17, 2020

Author: Healthwise Staff
Medical Review:
E. Gregory Thompson MD - Internal Medicine
Kathleen Romito MD - Family Medicine
Kenneth Bark MD - General Surgery, Colon and Rectal Surgery

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