Bowel resection for colorectal cancer

Surgery Overview

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Resection is another name for any operation that removes tissue or part of an organ. Bowel resection, also called partial colectomy, for colorectal cancer removes the tumor and part of the colon or rectum on either side.

The goal of bowel resection is to take out the part of the colon or rectum where the cancer is. Nearby lymph nodes are taken out and tested for cancer. Then healthy parts of the colon or rectum are sewn back together. Bowel resection is done either by opening the abdomen (open resection), or by laparoscopy.

View the slideshow on bowel resection to see what happens during this surgery.

What To Expect After Surgery

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Bowel resection requires general anesthesia. You may stay in the hospital for 4 to 7 days or as long as 2 weeks after surgery.

Sometimes the two parts of the colon or rectum cannot be reattached, so the surgeon performs a colostomy. This creates an opening, called a stoma, on the outside of the body for the stool, or feces, to pass through into a colostomy bag. Usually the colostomy is temporary, until the colon or rectum heals. If the lower part of the rectum has been removed, the colostomy is permanent. Most people who have colon cancer don't need a colostomy.

Treatment after bowel resection may include radiation therapy and chemotherapy, in case there are any cancer cells remaining. Radiation therapy uses X-rays to kill cancer cells. Chemotherapy uses drugs—given either as pills or through a needle—to kill them.

Follow-up care is important because colorectal cancer can come back after surgery, especially if it was not discovered when it is in an early stage.

Why It Is Done

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In early-stage cancer, surgery is done to remove as much cancer as possible to give the greatest chance of a cure.

In cases of advanced colorectal cancer that has spread (metastasized) to other parts of the body, bowel resection is often done to remove tumors that are blocking the intestine or causing bleeding.

How Well It Works

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When colorectal cancer is caught before it has grown into the tissue and muscle layers of the colon or rectum, bowel resection cures the disease most of the time. When the cancer has spread to those tissues, surgery is less likely to result in a cure. Overall, the operation cures the disease about half the time.¹

Bowel resection is the most successful treatment for colorectal cancer. Even if the cancer has spread to other parts of the body, bowel resection frequently relieves symptoms caused by blockage.²

Risks

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Possible complications after a bowel resection include infection, bleeding, or scar tissue formation (adhesions).

What To Think About

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This operation does not usually cause problems, even in older people. Age should not be a reason to avoid having a bowel resection.

In some cases, bowel resection can be done with a laparoscopy. Laparoscopy for bowel resection usually involves 3 to 6 very small incisions instead of one large one. Recovery time is faster as a result.

You and your doctor will think about several things in deciding whether you should have open resection or a laparoscopy. These include:

• The location and extent of the cancer.
• Your general health.
• Whether you have scar tissue in the area from previous surgery.
• Your doctor's expertise and experience.

Occasionally a laparoscopic surgery has to be changed to an open resection during the surgery.

Complete the surgery information form (PDF) (What is a PDF document?) to help you prepare for this surgery.

References

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Citations

1. National Cancer Institute (2007). Colon Cancer PDQ: Treatment—Health Professional Version. Available online: http://www.cancer.gov/cancertopics/pdq/treatment/colon/healthprofessional/.

2. Levin B (2006). Colorectal cancer. In DC Dale, DD Federman, eds., ACP Medicine, section 12, chap. 5. New York: WebMD.

Credits

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Author	Bets Davis, MFA
Editor	Maria Essig
Editor	Susan Van Houten, RN, BSN, MBA
Associate Editor	Pat Truman, MATC
Primary Medical Reviewer	Anne C. Poinier, MD - Internal Medicine
Specialist Medical Reviewer	Arvydas D. Vanagunas, MD - Gastroenterology
Last Updated	October 1, 2008