Colorectal Cancer Surgery

Colorectal cancer, comprising colon as well as rectum cancers, is one of the leading causes of death due to cancer. Surgical intervention, in its place, is most often practiced for localized colorectal cancer and in many cases provides a good prognosis when done early. Colorectal cancer surgery intends to remove the tumor and surrounding tissue so as not to let cancerous cells spread and allow for a better chance of survival. We will cover types of colorectal cancer surgery, steps involved in the procedure, benefits, costs, and recovery associated with this along with the best hospitals in India for handling treatment related to colorectal cancer.

What is Colorectal Cancer Surgery?

Surgeries involving colorectal cancer involve extracting cancerous tissues from the rectum or the colon. Surgeons will determine the extent of this surgery regarding the location as well as the staging of the actual cancer. Depending upon the part, they might only need to remove half of the length of the affected area, but sometimes they must completely remove that section. At times, such surgery also implies the removal of several lymph nodes at the site with a view of determining whether cells have spread there.

Why is surgery carried out for colorectal cancer?

Surgeons perform surgery for several reasons in the treatment of colorectal cancer: They remove malignant tissue: the overall objective of colorectal cancer surgery is to remove the tumor and adjacent tissue that is malignant to ensure the cancer cells do not metastasize into other parts of the body.

• To relieve symptoms: Surgery can also help relieve symptoms such as pain, bleeding, or bowel obstruction caused by the tumor.
• To restore function: In some instances, the surgeon can reconstruct the bowel to resume normal function after removing the cancerous tissue.

Types of Colorectal Cancer Surgery

1. Colectomy

Colectomy is the surgical removal of a portion or all of the colon.

• Procedure: The surgeon cuts out the section of the colon containing the tumor and then joins the healthy parts together. In some cases, a temporary or permanent colostomy might be necessary, with a small opening on the abdomen where the waste would exit.
• Indication: Surgeons usually perform laparoscopic colectomy when colon cancer has only localized lesions; that is, the lesions are confined to one part of the colon.

2. Laparoscopic Colectomy (Minimally Invasive)

Laparoscopic colectomy is a minimally invasive surgery that involves small incisions, using a camera to guide the surgeon to remove the affected area.

• Procedure: Small incisions are made and a camera along with special instruments is used to remove the part of the colon where cancer exists. It results in quick recovery and decreased scarring.
• Indication: Laparoscopic surgery is applied to those tumors that are localized in the colon and may be removed without causing much disruption.

3. Proctectomy

Proctectomy is a procedure in which the rectum is removed in the event of rectal cancer.

• Procedure: The entire rectum is removed, and a colostomy or ileostomy may be created for waste removal. Sometimes, the surgeon will attempt to save bowel function through a technique known as anastomosis, where the remaining colon is joined to the anus.
• Indication: The main indication of proctectomy is rectal cancer that falls in the lower rectum region.

4. Abdominoperineal Resection (APR)

APR involves the removal of the rectum, anus, and surrounding tissues and is undertaken when the disease is close to the anus.

• Procedure: A surgeon removes the rectum, anus, and several surrounding tissues, which causes a permanent ostomy for defecation to be done externally.
• Indication: Surgeons undertake this type of surgery when cancer is close to the anus, which disallows resection with the retention of bowel continuity.

Lymphadenectomy

In many instances, lymph nodes surrounding the tumor are also taken to be tested for the spread of cancer cells.

• Procedure: The surgeon takes out the affected lymph nodes in the abdomen or pelvis beside the tumor.
• Indication: Lymphadenectomy is performed mostly during other colorectal cancer surgeries, especially if there is suspicion that the cancer has spread.

Procedure Steps

• Anesthesia: The patient is put under general anesthesia before surgery.
• Incision: According to the kind of surgery—open surgery or laparoscopic surgery—the surgeon will make incisions in the abdomen or rectum.
• Tumor Removal: The tumor and its surrounding tissue, including lymph nodes, are removed. Sometimes, surgeons make a temporary or permanent colostomy.
• Reconstruction: A surgeon can join the remaining colon or rectum together or perform a colostomy or ileostomy where waste can exit the body.
• Closure: The surgical team will then close the incisions, and the staff can take the patient into recovery.

Benefits of Colorectal Cancer Surgery

Colorectal cancer surgery has numerous benefits.

• Possible cure: Colorectal cancer surgery is curative at various stages, especially at the beginning when the presence of the whole tumor is removed.
• Higher survival rates: Surgical treatment may be able to prevent the cancer from spreading to other parts of the body, hence increasing the chances of survival.
• Relief of symptoms: Surgery can help to relieve symptoms associated with colorectal cancer, such as bowel obstruction, bleeding, and pain.
• Better quality of life: Removing the cancerous tissue improves the quality of life of patients and reduces symptoms.

Cost of Colorectal Cancer Surgery

• Colectomy: $5,000 – $7,500
• Laparoscopic Colectomy: $6,000 – $9,000
• Proctectomy: $6,000 – $8,000
• APR: $7,500 – $10,000
• Lymphadenectomy: $2,000 – $4,000

India offers relatively low-cost and super specialty treatments to international patients, thus an excellent destination for colorectal cancer surgery.

Cost of Colorectal Cancer Surgery

Here’s the cost comparison of colorectal cancer surgery in various countries:

• United States: $25,000 and $35,000
• United Kingdom: $12,000 to $20,000 
• India: $2,000 to $10,000

Best Hospitals in India for Colorectal Cancer Surgery

India has among the best hospitals for the treatment of colorectal cancer, starting from advanced surgery to postoperative care. A few of the best hospitals include:

• Metro Hospital Faridabad
• Max Super Speciality Hospital, Delhi NCR
• Medanta—The Medicity—Gurgaon
• Fortis Memorial Research Institute, Gurgaon, Delhi NCR

Risks and Complications

Like any surgery, the surgeries of colorectal cancer have potential risks and complications:

• Infection: The site of surgery could become infected. It might necessitate antibiotics or further treatment.
• Bleeding: Surgery could cause excessive bleeding, especially when the cancer has reached an advanced stage.
• Bowel dysfunction: Bowel function could be lost in some patients after surgery, which might cause incontinence or constipation.
• Anastomotic leak: When reconnecting the bowel during surgery, there is always a chance that the connection leaks, leading to infection.
• Blood clots: Blood clots in the legs or lungs are a risk after any major surgery.

Recovery

Recovery after surgery for colorectal cancer is variable and depends on the type and complexity of the procedure.

• In-hospital Stay: Most patients stay in the hospital for about 5-7 days after surgery.
• Early Recovery: Recovery can take 2-4 weeks for lesser surgical procedures such as colectomy and up to 6-8 weeks with more invasive surgical procedures like APR.
• Long-term recovery: Patients may require months to get better and normalize activities. Post-surgery care would be visits from the specialist and possibly chemotherapy followed by physiotherapy.

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