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Annually, more than 800,000 people are diagnosed with rectal cancer around the world. The most effective method rectal cancer treatment is surgery of a malignant neoplasm. There are several methods of removing the tumor in the rectum. The specialist assigns the type of operation depending on the stage of the disease, the size of the malignant neoplasm, the presence of metastases, the condition of the surrounding tissues and the patient individual characters as a whole. What are the risks of surgery of a tumor of the rectum? What are the safest types of surgery for rectal cancer? Which clinics do conduct better? And what kind of lifestyle to lead after the operation? The answers to these and other exciting questions about surgery for rectal cancer are here in this article by MediGlobus.
READ IN ARTICLE:
Risks of surgery for colorectal cancer
Transanal resection for rectal cancer
Intraperitoneal resection for rectal cancer
Abdomino-perineal resection for rectal cancer
Operation Hartmann in case of rectal cancer
Palliative surgery for colorectal cancer
Lifestyle after surgery for colorectal cancer
MAIN COMPLEXITIES OF OPERATION
Risks of operation in tumor of rectum are due to the anatomical structure and localization of an organ. Important nerve endings that are responsible for the function of the bladder, prostate, seminal vesicles and urethra – in men, as well as the vagina, uterus and bladder – in women are near the rectum.
One of the main complications of surgery for colorectal cancer is the likelihood of damage to the surrounding vessels, nerves and tissues. Even minor damage during surgical resection of the neoplasm can lead to impairment of the functions of the reproductive and urinary system.
The cure of rectal cancer abroad is focused on the safe removal of the neoplasm. In the clinics of Israel, Korea, Germany and Turkey, advanced nerve-preserving surgeries are carried out in stage 1 till stage 3 of rectal cancer.
To remove malignant neoplasms, specialists use high-tech ultrasound instruments to disconnect tissues, which minimize the risk of damage to important nerves, bleeding and postoperative complications.
BASIC SURGICAL METHODS
TRANSANAL RESECTION
In stage 1 rectal cancer the tumor is not far from the anus and does not penetrate into the intestinal wall. In such cases, surgeons perform a local transanal resection.
This type of surgical intervention excludes cuts on the skin, as surgical instruments are injected directly through the rectum.
The neoplasm and the affected tissues are removed through the intestinal wall, after which it is sutured to the preoperative state. Local transanal resection is performed under local anesthesia.
After this type of operation for rectal cancer, the patient is prescribed a course of radiotherapy, often in combination with chemotherapy, to get rid of the maximum number of pathological cells and prevent recurrence of the disease.
In the clinics of Israel, Korea, Germany and Turkey, radiation therapy is carried out with the help of the newest linear accelerators, which direct large doses of radiation directly on the tumor, bypassing healthy tissues with an accuracy of 2 mm.
If a malignant neoplasm is spotted in the early stages and is located in hard-to-reach localization in the rectal region, then the surgeons conduct the transanal endoscopic micro-operation with the help of high-precision manipulator tools.
INTRAPERITONEAL RESECTION
If the rectal neoplasm is in stage 1-3 is located more than 10 cm above the internal sphincter of the anus, then the specialists prescribe the intraperitoneal resection to patient . At this stage, the neoplasm sprouts into the intestinal wall, but does not go beyond it. The tumor size is up to 2 cm and there are no metastases.
The operation involves open or laparoscopic surgery. During anterior resection, the malignant neoplasm of the rectum is removed along with a portion of the healthy tissue adherent to it, the nearest lymph nodes and surrounding pararectal tissue. After removing the affected areas, the surgeon connects the end of the rectum to the end of the colon. Most often this procedure is performed during the operation.
But patients who underwent a course of chemotherapy or radiotherapy before tumor surgery, first impose a temporary ileostomy (temporary channel for outflow of fecal matter), which is closed after 8 weeks and impose an anastomosis (creating a detour for food by sewing two parts of the gut).
ABDOMINOPERINEAL RESECTION
If the tumor with rectal cancer in stages 1-3 is located low and begins to sprout into the internal sphincter of the anus, surgeons resort to abdominoperineal resection procedure.
The operation is performed through the incisions on the abdomen and in the anus. The anus is removed during the operation. After abdominoperineal resection surgery, the patient is provided a permanent artificial anus.
OPERATION HARTMAN
Cancer of the rectum can be accompanied by obstruction of the intestine, inflammation of the peritoneum and bleeding.
In the presence of such complications, patients are prescribed an operation according to Hartmann.
This type of operation for rectal cancer involves the removal of the affected area of the rectum and suturing the distal end of the intestine.
The final stage of Hartmann’s operation is the resection of the end of the intestine on the abdominal wall and the formation of an artificial anus (colostomy).
PALLIATIVE SURGERY IN RECTAL CANCER
Palliative intervention for rectal cancer makes it possible to improve the quality of life of inoperable cancer patients, prevent the development of the disease and disrupt the work of the nearest organs to the tumor.
Abroad, successful palliative operations are carried out, in particular:
- Restoration of intestinal permeability by removing the constant stoma at the level of the small or large intestine;
- Urostomy (formation of the stoma in the wider part of the urethra) and nephrostomy (urine drainage from the kidney via drainage, stent or catheter);
- Prevention of biliary dysfunction;
- The introduction of a central venous catheter for parenteral administration of nutrients in case of serious disorders of the gastrointestinal function, which exclude the possibility of eating.
LIFESTYLE AFTER OPERATION WITH RECTAL CANCER
After surgery for colon cancer, patients need to eat properly and follow a healthy diet. Diet should always include fresh vegetables, fruits with limiting the consumption of fats and meat.
It is necessary to eat 4-5 times a day to quickly start metabolism and prevent problems with the intestines.
Patients with a colostomy should drink a daily dose of water (1-2 liters), as well as exclude from the diet sweet, rice, flour.
It is necessary to regularly undergo tests within 2 years after the operation, do diagnostic colonoscopy and perform a chest X-ray.
If the patient does not show any alarming indicators during this time, the following examinations should be conducted every 5 years. It is also worth noting that heavy physical exercise is contraindicated to the patient for the first 2-3 months after surgery.
Important! Be sure to consult your physician about the diet after surgery for colorectal cancer and follow his recommendations.
WHERE IS ITS BEST TO DO THE OPERATION WITH COLORECTAL CANCER?
More and more patients from the developing countries prefer to conduct surgical treatment of colorectal cancer abroad. In the leading clinics abroad there are effective nerve-preserving surgeries for colorectal cancer in all stages.
To get more informed on the surgical techniques of rectal cancer abroad, prices, finding the most suitable clinic and a unique package of medical services – contact the coordinators of MediGlobus by leaving a query on site.
