Colorectal Cancer Surgery
Colorectal cancer describes cancers arising from the large bowel and rectum. When caught at an early stage, surgical treatment changes the course of the disease markedly. Op. Dr. Aydın Dincer is a general surgeon with society memberships and congress training in colorectal surgery.
Key points in colorectal cancer surgery
- The segment of bowel containing the tumour is removed together with the vessels and lymph nodes that supply it.
- In colon cancer the two bowel ends are usually joined and digestion continues.
- In rectal cancer the distance of the tumour from the anus is the main factor determining whether a permanent stoma is needed.
- In rectal operations robotic surgery makes working within the narrow pelvis easier.
- Radiotherapy and chemotherapy before surgery are a frequent approach in rectal cancer.
Colon cancer surgery
The segment of colon containing the tumour is removed together with its lymph nodes, beginning at the root of the main supplying vessel. The remaining bowel ends are sutured together so that the digestive tract is preserved.
The oncological adequacy of the operation is judged by resection margins clear of tumour and by an adequate number of lymph nodes examined. In suitable patients the operation can be completed by the keyhole method.
Rectal cancer and the question of a stoma
The rectum lies within the narrow confines of the pelvis. The standard here is to remove the rectum together with its surrounding fat and lymphatic tissue in one intact envelope (TME). Removing that envelope without tearing it directly affects the risk of local recurrence.
What concerns patients most is the need for a permanent bag (stoma). If the tumour is not very close to the anus, the bowel ends can be joined and a permanent stoma is not needed. A temporary protective stoma may be created for a few months so that the join heals safely; this is closed at a second, smaller operation.
The place of robotic surgery in the rectum
A narrow pelvis, particularly in male and overweight patients, pushes laparoscopic instruments to the limit of their angles. The wristed instruments and three-dimensional view of the robotic system allow more controlled dissection in this space.
Preserving the nerves responsible for urinary continence and sexual function depends directly on that precision.
Why screening matters
Most colorectal cancers develop from benign polyps that turn malignant over years. When those polyps are found and removed at colonoscopy, cancer can be prevented before it develops.
People with a family history of colon cancer begin screening at an earlier age. Blood in the stool, a change in bowel habit, unexplained anaemia and weight loss should be assessed without delay.
Key facts
| Common operations | Right/left hemicolectomy, sigmoid resection, low anterior resection |
|---|---|
| Method | Laparoscopic, robotic or open |
| Standard in the rectum | Total mesorectal excision (TME) |
| Hospital stay | Usually 4–7 days |
| Stoma | Not needed in most patients; where required it is usually temporary |
| Follow-up | Regular colonoscopy, tumour markers and imaging |
Frequently asked questions
Will I need a bag after colon cancer surgery?
In most colon cancers the bowel ends are joined and no stoma is required. The need for a stoma arises mainly with rectal tumours close to the anus and in emergency operations for obstruction.
When is a temporary stoma closed?
Once the join has healed and any additional treatment is complete, usually within a few months, at a second operation. The timing is decided individually.
Why is radiotherapy given before surgery?
In rectal cancer, radiotherapy and chemotherapy before surgery can shrink the tumour, making the operation easier and reducing the risk of local recurrence. The decision is taken by the oncology board.
Will my bowel habit change after surgery?
Temporary changes in stool frequency and urgency can follow rectal operations in particular. These generally improve with time and dietary adjustment.
At what age should colonoscopy screening begin?
For people without risk factors, screening generally begins between 45 and 50. Those with a family history of colon cancer or polyps should start earlier; the right age should be decided with your doctor.
The information on this page is for general guidance only and does not replace a consultation. The treatment that suits you can only be determined after examination and tests.
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