Colon and Rectal Surgery
The best way to potentially cure colorectal cancer is to diagnose it in its early stages. The general population typically undergoes aggressive screening techniques, especially those with risk factors. Most, but not all, colorectal cancers begin as benign polyps which are pre-malignant growths within the bowel wall. These benign polyps eventually can progress to a cancer. The polyps are often identified on a colonoscopy. A colonoscopy is often performed on people with symptoms of change in bowel habits, rectal bleeding, diarrhea or constipation and abdominal pain. Polyps that are identified can often be removed endoscopically, but if they are not amenable to endoscopic removals, they may require a surgical resection. Often, benign polyps can be removed with laparoscopic surgery. Minimally invasive techniques utilizing the laparoscope allow for the colon to be removed and brought out through a small incision. This decreases the patient’s post-operative pain, limits the length of hospitalization, and increases the speed of recovery.
The treatment of rectal cancers and polyps is often tailored to the extent of disease present. Benign polyps and early cancers can often be removed transanally. When advanced cancers are identified, sphincter-preserving methods often can be utilized to preserve the patient’s anal continence. Diverticular disease can involve recurrent bouts of abdominal pain, which is often crampy and associated with altered bowel habits. In addition, diverticular disease can involve rectal bleeding. Diverticulitis can occur and cause severe pain, fever, chills, change in bowel habits, and even perforation, abscess, or fistula formation. If diverticular disease is severe enough to require surgery, the procedure often can be performed with minimally invasive techniques. Laparoscopic colon resections can be performed for diverticular disease again decreasing the postoperative pain, time of hospitalization and recovery time.
In addition to colorectal cancer and diverticular disease, inflammatory bowel disease often requires surgical intervention. These resections often are used for Crohn’s disease secondary to chronic obstruction of the bowel, fistula formation, and bleeding. Ulcerative colitis is usually treated with medications, but when the disease becomes refractory to medical therapy, surgical intervention often is required. The surgical procedure involves the removal of the diseased colon and rectum and the creation of a new neorectum with an ileal pouch anal anastomosis procedure.
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