What is colon cancer?

Colon cancer is a harmful growth that starts in the wall of your colon (large bowel).

A colon resection involves removing the cancer along with part of your colon either side of it.

What are the benefits of surgery?

The aim is to remove the cancer along with part of your colon either side of it.

Are there any alternatives to a colon resection?

Chemotherapy or biological therapy will not lead to you being cured but can shrink the cancer.

It is possible to have procedures to ease any blockage of your bowel without treating the underlying cancer. These include forming a stoma (your bowel opening onto your skin) or inserting a stent (metal mesh tube) across the cancer to hold your colon open.

What will happen if I decide not to have the operation?

The cancer will continue to grow and will often bleed slowly.

As the cancer continues to spread, it may start to block your bowel, leading to abdominal pain and making you feel sick. The cancer can also spread to other areas of your body.

What does the operation involve?

The operation is performed under a general anaesthetic and usually takes about 90 minutes.

Your surgeon will remove the cancer along with part of your colon either side of it. Your surgeon will remove lymph nodes (glands) close to where the cancer was to find out if there are any cancer cells in them.

Your surgeon will usually join the ends of your bowel back together inside your abdomen. Sometimes, for safety reasons, they will make a stoma.

What complications can happen?

The healthcare team will try to reduce the risk of complications.

Any numbers which relate to risk are from studies of people who have had this operation. Your doctor may be able to tell you if the risk of a complication is higher or lower for you. Some risks are higher if you are older, obese, you are a smoker or have other health problems. These health problems include diabetes, heart disease or lung disease.

Some complications can be serious.

General complications of any operation

• Bleeding during or after the operation. You may need a blood transfusion or another operation.
• Infection of the surgical site (wound).
• Allergic reaction to the equipment, materials or medication.
• Acute kidney injury.
• Developing a hernia in the scar.
• Blood clot in your leg (deep-vein thrombosis – DVT).
• Blood clot in your lung (pulmonary embolus), if a blood clot moves through your bloodstream to your lungs.
• Chest infection. Your risk will be lower if you have stopped smoking and you are free of COVID-19. (coronavirus) symptoms for at least 7 weeks before the operation.
• Difficulty passing urine.

Specific complications of this operation

Keyhole surgery complications

• Damage to structures such as your bowel, bladder or blood vessels when inserting instruments into your abdomen. If an injury does happen, you may need open surgery.
• Developing a hernia near one of the cuts used to insert the ports.
• Surgical emphysema (a crackling sensation in your skin caused by trapped carbon dioxide).
• Gas embolism. This is when gas (carbon dioxide) gets into the bloodstream and blocks a blood vessel. This is very rare but can be serious.

Colon resection complications

• Anastomotic leak. There are different management options. You may be given antibiotics or a drain may be placed through your skin to remove any infected fluid. In most cases, an emergency operation is needed which usually involves formation of a stoma.
• Continued bowel paralysis, where your bowel stops working for more than a few days, causing you to become bloated and to be sick.
• Damage to other structures inside your abdomen.
• Tissues can join together in an abnormal way (adhesions) when scar tissue develops inside your abdomen.
• Compartment syndrome causing pain and damage to your legs.
• Death.

Consequences of this procedure

• pain
• unsightly scarring of your skin

How soon will I recover?

Getting out of bed and walking is an important part of your recovery. You may also be given breathing or other exercises to do.

If you have a temporary or permanent stoma, you will need to learn how to change the bag and care for your stoma.

You should be able to go home after 2 to 7 days.

It may take up to 3 months for you to recover fully.

Regular exercise should help you to return to normal activities as soon as possible. Before you start exercising, ask the healthcare team or your GP for advice.

The tissue and lymph nodes that your surgeon removed will usually be examined under a microscope. If cancer cells were found in some of your lymph nodes which were removed, you may need more treatment (chemotherapy).

Summary

Removing the cancer by surgery gives you the best chance of being free of colon cancer.

IMPORTANT INFORMATION

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