Surgery for Rectal Cancer
Rectal cancer is a relatively common malignancy of the gastrointestinal tract. Surgery aims mainly to cure the condition and avoid the spread of the tumor because these can often be very detrimental to the life expectancy and the quality of life of the patient.
Surgery for Rectal Cancer
Rectal cancer is a relatively common malignancy of the gastrointestinal tract. It can occur as a result of many causes but the most implicated is the HPV virus (Human papillomavirus). Surgery aims mainly to cure the condition and avoid the spread of the tumor because these can often be very detrimental to the life expectancy and the quality of life of the patient.
- The surgery is done to eliminate the clinical signs and symptoms that are congruent to that of rectal cancer such as bleeding per rectum, early-morning diarrhea, and tenesmus.
- This surgery also aims to reduce the instance of tumor spread through the vasculature, lymphatics and local spread of the tumor, worsening the clinical signs and symptoms.
- The surgery is done as a measure of palliative care to the patient in advanced stages of the disease. Extreme suffering of the patient seen if the neoplasm remains without being resected.
How is this procedure done?
- The patient should be assessed if they are fit for the surgery
- The patient should be well sedated free of any pain. General anesthesia is employed for this.
- Radical excision of the neoplasm
- Removal of the mesorectum.
- There is a high proximal ligation of the inferior mesenteric lymphovascular pedicle
- Once the rectum has been mobilized well, it is removed and the rectal stump is washed out.
- Finally the restoration of the continuity through the direct end-to-end anastomosis.
Risk of this procedure
- Disturbances in the sexual function especially impotence
- Bladder dysfunction
- Rectal sphincter might not be able to be saved during the procedure based on the extent of the tumor
Because of the nature of the surgery, the patient is required to have a temporary urinary
catheter to deliver the formed urine from the urinary bladder to prevent the bladder from
becoming overfull during the surgery.
Recovery after surgery
- The lower a tumor is in the rectum, the worse the prognosis as compared to a higher-up tumor in the rectum.
- If the histological classification of the tumor shows it an anaplastic lesion, a worse prognosis is expected.
- Fixed neoplasms in the rectum usually have a far worse prognosis compared to mobile lesions.
Expect a local recurrence of the condition after surgery with rates of up to 2% to 25% with
higher rates expected after abdominoperineal excision as compared to the sphincter-saving