Roderich Schwarz in GI Clinic

Colon Cancer Surgery

Removing cancer by surgery is a common first step for patients with colon cancer, and a possible second step after chemotherapy for patients with rectal cancer.

A Leader in Colon Surgery

We are named a High Performing Hospital for Colon Surgery by U.S. News & World Report, a designation that reflects our exceptional ranking for survival rates, number of procedures performed, nurse-to-patient ratio, and proportion of patients able to return home and post-surgery and resume normal activities

Our surgeons perform the majority of colon and rectal surgeries with minimally invasive techniques such as laparoscopic or robotic procedures. These approaches offer patients several benefits over traditional, open surgery, including:

  • Smaller incisions that heal faster with less scarring
  • Less pain
  • Shorter hospital stay
  • Faster recovery

To treat your cancer, our colorectal surgeons may recommend one of the following procedures:

  • Colectomy to remove the portion of the colon containing the cancer and reconnect the healthy portions back together. How much of the colon is removed depends on your blood supply, the drainage patterns of your lymph nodes, the tumor’s location and the extent of your disease.
  • Transanal endoscopic microsurgery (TEM) is a minimally invasive surgical procedure performed through the anus for early-stage rectal tumors or in patients who have several other health conditions that make other surgery types too risky for them.
  • Endoscopic mucosal resection (EMR) is a minimally-invasive procedure performed through an endoscope to remove early tumors of the colon or rectum.
  • Lymph node surgery to remove the lymph nodes associated with the portion of the colon or rectum that is removed is an important part of treatment and staging. These lymph nodes must be analyzed properly to determine whether they contain any cancerous cells. Cancer that has spread to lymph nodes means you’ll likely need other treatment beyond surgery, such as chemotherapy.
  • Total Mesorectal Excision (TME) is a critical procedure for patients with rectal cancer. This surgery removes the rectum along with the surrounding lymphatic tissue, called the mesorectum. Ensuring complete removal by a skilled surgeon is essential to reduce risk for recurrent cancer.

The Roswell Park Advantage

In cancer surgery, the ability to remove the cancer entirely and achieve a clear (or negative) margin — where the tissue surrounding the tumor is cancer-free — is paramount to curing the cancer. Roswell Park has unique capabilities to ensure clear margins or treat any high risk (or positive) margins, such as:

  • Mid-procedure pathology review allows tissue samples from the margin area to be analyzed by a pathologist on the spot, confirming cancer-free margins before the surgery is completed.
  • Intraoperative radiotherapy delivers radiation to the margin area during the operation to kill any residual, microscopic cancer cells.

Will I Need an Ostomy (Colostomy or Ileostomy) Bag?

When surgeons need to remove a section of the colon or rectum to effectively remove all the cancer, sometimes reconnecting the healthy parts of the colon isn’t possible. In these cases, the surgeon creates a new path for waste to leave the body through an opening (stoma) in the wall of the abdomen. Waste is collected in a flat pouch worn outside of the body. The operation to create a stoma from the large intestine — the colon — is called a colostomy. Creating a stoma from the small intestine is called an ileostomy.

For most people, this stoma is temporary. Once the colon or rectum heals, the surgeon can reconnect the healthy portions and close the stoma. For some rectal cancer patients, especially those who undergo chemotherapy and radiation prior to surgery, a temporary loop ileostomy will be in place for several weeks to allow healing time and completion of other therapy. When the time is right, the ileostomy is removed with another small surgical procedure. Learn more about ostomy reversal.

Whether or not a colostomy is permanent depends on the cancer’s stage and how close the tumor is located to the muscles that control bowel movements (the sphincter muscles) and how well these muscles function prior to surgery. In certain rectal cancers, chemotherapy and radiation treatment before surgery may reduce the need for a permanent colostomy. However, for some patients, such as those who suffer incontinence, a colostomy can improve quality of life.

Roswell Park performs a high volume of these complex surgeries and a high number of our patients avoid a permanent colostomy.

Living with an Ostomy

Whether your ostomy is temporary or permanent, it can be an adjustment. Roswell Park offers an Ostomy Support Group to provide education and support to patients and caregivers learning to manage an ostomy.