Colon cancer or carcinoma is very common cancer. Most colon cancers are diagnosed by colonoscopy (scope used to examine the colon from the inside of the colon). Often, colon polyps can be seen as well. Some polyps are large and may have small amounts of cancer or are at great risk for developing cancer. These patients should undergo removal of a portion of their colon known as a colon resection. All patients with colon cancer should undergo a colon resection. The goal of a colon resection is to remove the cancer or pre-cancerous polyp with areas of normal colon on either side with a good sampling of the lymph nodes present among the blood vessels. The pathologist to determine how invasive or advanced the cancer may be then examines the colon and the lymph nodes. These results will then determine if further therapy may be needed.
Colon Carcinoma Surgery
Colon resections can be performed in either an open or a laparoscopic fashion. We specialize in minimally invasive or laparoscopic techniques that provide a patient with smaller incisions, a quicker return to bowel function, and shorter recovery.
A laparoscopic-assisted colon resection is performed through 3 to 4 small incisions and a larger incision for a hand port. A hand port allows for ease of the laparoscopic technique performed with the assistance of a camera known as a laparoscope. In addition, the hand port protects against recurrence at the skin site, which was an early concern with the laparoscopic technique.
A similar procedure known as a laparoscopic-assisted low anterior resection can be performed for rectal cancers as well. In both resections, the colon is dissected away from its attachments. The colon and its blood vessels (mesentery) are then divided. The colon is divided again and the two ends are reconnected.
The patient usually stays in the hospital anywhere from 2 to 10 days. A patient must be having bowel movements, eating, and walking around prior to returning home.
- Bowel preparation is required for this operation. A prescription is given for the bowel prep that should be taken over 4 hours. The bowel will then continue to empty hopefully until stool is clear.
- Antibiotics will be prescribed prior to surgery as well. These also help to rid the bowel of the bacteria that usually lives there to make the bowel as clean as possible.
- A clear liquid diet should be taken the day before surgery. Clear liquids are liquids that you can see through including water, apple juice, coffee, tee, broths, and Jell-O.
- A patient should not eat or drink anything after midnight the night before surgery.
- Lab work may be required prior to surgery. This will be scheduled for you.
- Clearance by your primary care physician or a cardiologist may be required prior to surgery.
- Please discontinue aspirin and any other blood thinners at least 5 days prior to your surgery. Call your primary care physician before discontinuing and prescription drugs.
- Your primary care physician or anesthesia should address other questions regarding your usual prescription medications.
- Resume a soft diet as tolerated. Before leaving the hospital, you should have eaten at least one meal.
- No heavy lifting for at least 4 weeeks.
- Resume other activities as tolerated with no lifting as above.
- Plan to be off from work for at least one week. Some people need two weeks to recover from this operation.
- Constipation can be common problem following this operation. Milk of magnesia, which is available over the counter, can often be helpful with this problem. Under no circumstances should an enema be used following this operation unless specifically recommended by your surgeon.
- Driving is not permitted while on narcotic pain medication (Vicodin) and while a patient is in sufficient pain as to not be able to use the brake effectively in an emergency. Driving is not recommended for several days.
- Incisions will have an outer dressing as well as an inner dressing. The outer dressing may be removed the day after surgery. A patient may shower at this time. The inner dressing will resemble band-aids and are known as steri-strips. These should be left in place and they will fall off on their own in 5 to 7 days.
- Sutures are usually placed underneath the skin and do not need to be removed. Occasionally, a patient may notice a thread or knot. This will dissolve on its own or can be removed in the office.