The main way to cure malignancy in the rectum is surgery. In the fight against tumors, current oncology combines few treatment methods. In some cases, in order to overcome cancer, a chemo - or radiotherapy course may be taken before the excision procedure. But the procedure to remove a malignant tumor is considered the most productive, albeit radical, method of curing this disease. Many patients are interested in what are the first symptoms of colorectal cancer, survival after surgery, and what rehabilitation period to completely overcome the disease?
Varieties of operations
If the neoplasm is diagnosed at an early stage (I), has not grown through the wall of the inside and is located near the anus, a local transanal resection or laser surgery of the rectum cancer is performed. During the procedure, no cuts are made on the skin: the doctor introduces the devices through the organ. An incision is made through the entire thickness of the intestinal wall. Eliminate the affected area and materials close to it, the resulting deficiency is sutured.
Local transanal resection is performed under local anesthesia. During the procedure, the patient is conscious. Since the lymphoid areas are not excised, after the intervention they are undergoing a course of radiation therapy, in some cases in combination with chemotherapy, in order to eliminate the cancer cells remaining in the body.
If the neoplasm at stage I is located in the rectum rather high, then use a method called transanal endoscopy. In fact, this is the same transanal operation that is carried out with the support of the most time-consuming current equipment, which guarantees significant reliability of the intervention.
Front resection
In the first three stages, when the neoplasm is located 10 cm above the anal sphincter, anterior resection is performed. The procedure is performed by an open or laparoscopic method. The surgeon eliminates the tumor with the capture of a certain amount of healthy matter on both sides, as well as nearby lymphoid areas and the surrounding tissue. Then anastomosis is applied: the end of the rectum is combined with the end of the colon.
Most anastomosis is applied immediately during the time of resection. But, if chemotherapy or radiation therapy was done before the procedure, the rectum needs a period to resume, otherwise standard healing will not happen. A temporary ileostomy is applied to the patient: an opening is made in the ileum wall (end section of the small intestine) and it is inserted into the skin. As a rule, after two months the ileostomy is covered and an anastomosis is applied.
Low resection
The operation is performed with the formation of a tumor in the lower and middle part of the intestinal tract. This method is called total mesorectumectomy and is a common method in medicine for removing neoplasms directly in this part of the rectum. With this intervention, the doctor performs an almost absolute rectal elimination.
Hartmann's procedure
It is performed under the condition of intestinal obstruction, as an urgent measure, the Hartmann procedure is performed. Resection of the rectum and sigmoid inside is performed in the absence of an anastomosis with the formation of a colostomy.
Proctectomy
In some cases, the entire rectum and the lymphoid areas around it should be removed. This procedure is called proctectomy. It ends with the application of a colo-anal anastomosis - the end of the large intestinal tract is sutured to the anus.
Normally, the rectum acts as a container in which excrement masses accumulate. Already after proctectomy, this function will be performed by the final section of the colon. For the sake of this, the surgeon is able to form an unnatural J-shaped reservoir and apply an anastomosis according to the end-to-side view, which will help to reduce the frequency of bowel movements, and to ensure stool density as close to standard as possible.
Abdominal perineal surgery
The operation begins with 2 incisions - in the abdomen and perineum. The method is aimed at eliminating the rectum, areas of the anal canal and surrounding materials.
Local resection makes it possible to remove small tumors at the initial stage of the disease. For its implementation, an endoscope is used - an instrument with a small camera. Such endoscopic surgery makes it possible to safely combat neoplasms in the primary stages of the disease. In case the neoplasm is near the anus, the microendoscope may not be used by the doctor. Doctors remove a malignant tumor directly from the patient using surgical instruments. They are inserted into the anus.
Transanal excision
In modern medicine, there are new methods for the timely cure of the disease. They make it possible to preserve the organ sphincter, for this reason radical measures are rarely used in surgery. One of these methods is considered transanal excision.
The method is used to eliminate small tumors that are localized in the lower part. For the sake of performing the operation, specialized equipment and medical devices are used. They make it possible to eliminate minor areas of the rectum and preserve those around the tissue. This procedure is performed without eliminating lymphoid structures.
Laparoscopy
A cancerous tumor is also removed using open laparoscopy. With the laparoscopic method, the doctor makes a series of small incisions in the abdominal cavity. Then, an endoscope with a camera is inserted in them, which is equipped with a backlight. Surgical instruments for removing the tumor are inserted through other incisions. Such an operation differs from abdominal action by the rapid recovery phase and the technique of performing the surgical intervention.
After the procedure, most patients create a special stoma for excreting bowel movements. By itself, it is an artificial opening in the abdomen, to which a reservoir for collecting excrement mass is attached. Stoma is made from an open area of the intestinal tract. The opening is temporary or left forever. Short-term stoma is created by doctors to heal the rectum after anal intervention. This kind of opening is covered by doctors a few months later. A continuous opening is necessary only if the tumor was near the anus, low enough in the rectum.
If the tumor affects organs located near the rectum, extensive removal procedures are performed - pelvic exentration, which contains an inherent elimination of the urinary bladder, including the genitals.
Sometimes an oncological tumor can form an obstruction of the intestinal tract, blocking the organ and causing nausea and pain. In this situation, stenting or surgery is used. When stenting, a colonoscope is inserted into the blocked area, it keeps the intestine open. With the operational method, the blocked area is removed by the doctor, after which a short-term stoma is formed.
Abdomino-perineal resection
This type of surgical intervention is used in the first three stages, if the neoplasm is located low, it grows into the sphincter (muscle pulp in the anus, is responsible for maintaining excrement masses). The procedure is performed through incisions in the abdomen and in the anus. Since the anus will be removed, after abdomino-perineal resection, a long-term colostomy is applied: the end of the colon is brought to the skin, and the colopriem is attached.
It is allowed to divert the end of the intestine to the perineum. In fact, this is the same colostomy, however, it is located in the usual area, where the anus was previously.
Pelvic evisceration
This is the most significant surgical intervention that is performed during the germination of a tumor in the surrounding organs. The rectum and organs of the urethra are excised. Already after the action, a colostomy, urostomy (an opening in the anterior abdominal wall to drain urine) is applied.
Preparation for surgery
Surgery for colorectal cancer will require integral preparation. The day before the surgery, the intestinal tract is completely cleansed of excrement masses. These actions are necessary in order to ensure that the enterobacterial content of the inside does not fall into the peritoneum during the operation and does not provoke inflammation in the postoperative stage. In severe cases, if an infection enters the abdominal cavity, a dangerous complication may form, in the form of inflammation.
In preparation for a constructive operation, the doctor may prescribe specific pharmaceutical substances that make it possible to cleanse the intestinal tract. It is impossible to refuse to accept these funds. It is important to be guided by absolutely all medical advice - take the necessary amount of water, adhere to a diet for colon cancer before surgery, etc.
Rehabilitation
The operation requires compliance with absolutely all medical advice at the recovery stage. In some cases, chemotherapy is performed after rectal cancer surgery. It depends on the degree of the disease. The procedure makes it possible to improve the quality of life of patients and increases the survival rate for the disease. Today, doctors are aimed at implementing organ-preserving methods and are trying to bring to a minimum the number of diverse multifunctional pathologies of the body after the procedure. An intestinal anastomosis makes it possible to preserve the continuity of the inside and sphincter. In this case, the stoma is not inserted on the wall of the intestinal tract.
The postoperative period of colorectal cancer is still in intensive care. Under the supervision of staff, the patient leaves with anesthesia. Medical supervision will make it possible to localize the likely complication, prevents bleeding. On the second day after surgery, the doctor allows you to sit down.
After the operation, analgesics are prescribed, which relieve discomfort and pain. All medical ailments must be reported to the medical staff. Taking medications will make it possible to alleviate the situation. A doctor may determine spinal or epidural anesthesia by injection. Painkillers are injected into the body using droppers. A specially designed drainage can be placed in the area of the surgical wound, which serves to decrease excess water. After a few days, he cleans up.
Eating is allowed three days after the procedure. The menu necessarily consists only of soups in the form of mashed potatoes and liquid cereals. The food is not greasy, not salty and not seasoned with oil.
Survival at different stages of cancer
Many people are interested in how long they live after surgery for rectal cancer. It is difficult to give an answer, because it all depends on the stage of the disease and the body. Four stages of cancer are distinguished. Survival forecasts below:
- I. At this stage, the malignant formation only grows and does not have significant symptoms. Surgical removal is easier to carry out, and monitoring is therefore preferred. How long do rectal cancer live after surgery? The tumor at this stage has the most significant survival: more than 90%.
- II. A neoplasm at this stage is already more common, of a larger size, it can affect the surrounding organs of the genitourinary system. For this reason, approximately 75% of patients survive 5 years after cure. Reviews of rectal cancer surgery of stage 2 indicate a mild course of the recovery period and an increase in life expectancy.
- III. Only fifty percent of those who completed the procedure at this stage survive the next five years. And all because the destruction of regional lymph nodes is characteristic of the third degree.
- IV. This stage has dire consequences. It is characterized by the occurrence of metastases in other organs. If the neoplasm has a distribution in a single organ, then the prognosis improves, if in a pair, then this is a bad criterion. At this stage, only six percent of people can live five years.
At the first symptoms of colorectal cancer, urgent treatment is necessary, otherwise the consequences will be disastrous.