Surgical Approaches to Colorectal Cancer

Surgical Approaches to Colorectal Cancer

Colorectal cancer is one of the most prevalent cancers all over the world, with millions of people falling victim each year. Surgery is the most common treatment for this type of cancer, especially if it is detected in its early stages. With advancements in medical technology, surgical approaches to colorectal cancer have become more precise and less invasive in application. This reduces both the death rate and recovery time among patients.

The stage of your cancer will determine the kind of colorectal surgery you need. The surgeon does not have to make an incision in your belly to treat cancers that are still in their early stages; instead, they can do a local treatment. Nevertheless, more complex surgery that involves the removal of the colon and/or rectum entirely or in part may be necessary for advanced-stage malignancies. Tumour excision may be required in distant locations if the cancer has progressed to other bodily organs, such as the liver.

The article discusses the primary types of surgical treatments for colorectal cancers, such as open, conventional methods, minimally invasive methods, and more recent approaches that try to maximise benefits and reduce side effects.

Traditional Open Surgery

Resection of colorectal cancer is still most commonly accomplished by open surgery. A clear view of the area to be operated on is provided by the comparatively bigger incision made over the abdomen. This procedure allows more detailed examination and removal of tumours, especially in very complex cases. Mostly, advanced cases of colorectal cancer or large tumours or even wherein the cancer spreads to neighbouring organs are usually treated with open surgery. This procedure, known as colectomy or hemicolectomy, is effective in preventing cancer from spreading further.

Laparoscopic Surgery

Instead of making a single, massive cut, laparoscopic surgery, also known as minimally invasive surgery, makes several tiny incisions. Through the tiny holes, a camera and more specialised tools are inserted to do the procedure. Laparoscopic surgery has become more and more common since it can minimise discomfort and shorten recovery times.

The surgeon makes three to five small incisions in the abdomen, which are viewed on a monitor via the camera or laparoscope. The tumour and the affected lymph nodes are removed by the attending surgeon with the guidance of the camera. After that, the bowel is reattached, just like in open surgery. For many individuals with colorectal cancer in its early stages, this surgery is advised. Although it is not recommended for advanced cases or large tumours, it is a great choice for very accurate early cancer identification with minimal damage to adjacent tissues.

Robotic-Assisted Surgery

This novel method combines robotic precision with less invasive procedures. From a console, the surgeon controls robotic arms equipped with cameras and tools. Particularly for complex procedures, it is the most effective method that makes use of more control, accuracy, and visualisation. While seated at a console, the surgeon’s movements are converted into precise motions by the robotic arms. More complicated tasks can be done in confined locations because of the robotic tools’ ability to bend and spin in ways that human hands cannot. Only tiny incisions are required, much like in laparoscopic surgery.

Robotic-assisted surgery is especially useful for cancers in the lower rectum, where it may be difficult to access the case for surgery. The therapy method can be used for both early and certain advanced colorectal cancer cases, depending on the tumour’s features and the patient’s condition. Due to its high cost, robotic surgery is mainly utilised in conjunction with laparoscopic procedures. Robots are used to perform the majority of minimally invasive rectal cancer procedures.

Transanal Minimally Invasive Surgery (TAMIS)

By using the anus to enter the rectum rather than an external incision, TAMIS is a less invasive technique. Its advantage is in removing early tumours in the rectum that are near the anus. It is a less-invasive surgery than an open surgery, and the rectal function may be preserved.

To insert certain equipment that will reach the tumour and remove it, the surgeon creates incisions on the rear side. Since abdominal incisions are avoided, the risk of infection would be very minimal, and recovery would be fast. Because the surgery only focuses on the tumour, less tissue around the area is interfered with. TAMIS is appropriate for early-stage tumours where the cancer has not spread beyond the rectum. It is given mainly to patients whose cancers are small and located in the rectum.

Total Mesorectal Excision (TME)

A sophisticated surgical procedure called total mesorectal excision is mostly used to treat rectal cancer. The rectum and the mesorectum, or fatty tissue around the rectum, are removed by TME. The method is required to decrease recurrence since the mesorectum contains tissues and lymph nodes that may harbour cancer cells.

The goal of TME is to have a total excision of the rectum and mesorectum. Thus, the surgeon should be extremely careful during the procedure. The intervention can be performed either with an open or laparoscopic technique or using a robotic technique based on the extent of the case and based on the surgeon’s experience. TME is considered the gold standard for rectal cancer surgery; it is primarily used when the cancer has locally advanced within the rectum. It is often carried out in cases where the tumour is relatively large or close to the anal area.

Potential Complications Following Colorectal Cancer Surgery

Recovery from colorectal cancer surgery varies with each procedure and approach used. Talk to your medical team about what should be expected in the recovery process. The risks of these colorectal cancer treatments are the same as those of other surgical procedures. Your chances of bleeding, blood clots, and infections may increase as you recover after the operation. There is a chance that the place where your colon, rectum, or anus was reconnected may leak. The medical team will keep an eye out for any related symptoms, such as fever and appetite loss, and look for adhesions, which are scar tissue formations that might impair organ function after you leave the hospital. You can expect some pain post-surgery, which can be managed with medication.

Final Thoughts

There are several different surgical options for colorectal cancer, ranging from open surgery to sophisticated robotic and minimally invasive procedures. A number of variables, including the tumour’s location and stage, the patient’s health, and the surgeon’s skill level, would influence the surgical procedure. Technological developments have made colorectal cancer surgical procedures safer, less risky, and more successful. As a result, patients now have more confidence as they better address the threat posed by this potentially fatal diagnosis.

– Dr Simha