Robotic colorectal surgery since 2014
WELL-ESTABLISHED ENHANCED RECOVERY AFTER SURGERY (ERAS) PROGRAM
Multidisciplinary GI tumor board
Sphincter-sparing surgery for rectal carcinoma
Sacral nerve stimulation for fecal incontinence
Rectal Carcinoma is cancer that starts in the last few inches of the large intestine. Treatment for rectal cancer is different than for colon cancer, primarily because of the limited space in the rectum and its close proximity to other organs. That makes surgery to remove the cancer more difficult.
Who gets rectal cancer?
Like colon cancer, rectal cancer can develop at any age but the majority of people who develop rectal carcinomas are older than 50. However, as with colon cancer, the incidences of rectal carcinoma are increasing in people under 50 years of age.
Diet and family history are also risk factors. High fat diets with an emphasis on red meat put people at increased risk of developing rectal carcinomas, as does a diet low in fiber. Other risk factors include:
- Race. Black people are at greater risk.
- Cancer history. Previous bouts of rectal cancer, colon cancer or adenomatous polyps.
- IBD. Chronic inflammatory diseases such as ulcerative colitis or Crohn’s disease.
- Sedentary lifestyle
- Uncontrolled diabetes
- Alcohol. Consuming more than three alcoholic drinks per week.
- Radiation therapy. Previous radiation therapy directed at the stomach/abdomen area.
Symptoms of Rectal Carcinoma
The symptoms of rectal cancer are similar to that of colon cancer. They include:
- Changes in bowel habits, including diarrhea, constipation or increased need for bowel movements.
- Blood in the stool, particularly if it is bright red or maroon in color.
- A narrow stool.
- Constant feeling that you aren’t emptying your bowels.
- Pain in the abdomen.
- Weight loss.
Surgical Treatment of Rectal Carcinoma
You may need chemotherapy and/or radiation in addition to your surgery for rectal cancer. The tumor’s proximity to the anus determines the type of surgery being done.
- Polypectomy, In the early stages, the polyp can be removed during a colonoscopy, in a procedure called polypectomy, which calls for putting a wire loop through the colonoscope to lop off the polyp from the rectum with an electric current.
- Local excision. Your surgeon can also use a lccal excision for more involved procedures. Tools are passed through the colonoscope to take out the cancers that are on the interior lining along with a margin of healthy tissue on both sides of the carcinoma.
- Transanal excision. Your surgeon can useto excise small cancers close to the anus. Under local anesthesia, the instruments are put into the rectum through the anus and your surgeon cuts through the layers of the rectal wall to remove the cancer and surrounding tissue.
- Transanal endoscopic microsurgery (TEM). During your surgeon uses a special magnifying scope placed through the anus to remove tumors located high in the rectum.
- Low anterior resection. This surgery can be used for some stage I cancers, stage II and stage III cancers in the upper part of the rectum. The section of the rectum with the cancer is removed and then the lower part of the colon is attached to the rectum.
- Proctectomy with colo-anal anastomosis. For cancers in the middle and lower third of the rectum, removal of the entire rectum is needed. The colon is then attached to the anus.
- Abdominoperineal resection (APR). This type of operation is needed when the cancer has grown into the sphincter muscle or levator muscles. Your surgeon makes an incision or incisions, removes the rectum, anus and the tissue surrounding it, as well as the sphincter. This does require a permanent colostomy.
- Pelvic exenteration. This is required if the cancer has grown into nearby organs. Removal of the rectum and the organs the cancer has compromised are removed such as the bladder, uterus or prostate.
- Diverting colostomy. In some cases, your surgeon may divert the colon by cutting the colon above the cancer and attaching it to an opening in the skin of the abdomen so stool can come out. The cancer is bypassed so you can gain strength in order to start treatment such as chemotherapy.
Colorectal Disease Specialties We Treat