Sphincter Sparing Procedures for the treatment of Colorectal Cancer
Colorectal cancer is caused by the uncontrolled growth of cells in the colon or rectum. Bleeding in the rectum and anemia are the common symptoms of colorectal cancer. Colorectal cancer is caused mainly due to old age and life style problems. Genetic disorders are not a major cause for this type of cancer. Colorectal cancer affected on the wall of colon is curable by surgery. If the cancer is widely spread, then it is not curable by surgery. Then only palliative care can be given which will improve the quality of life of the patient.
Treatment for rectal cancer is considered based on the stage of development of cancer. There are 4 stages of cancer. They are:
Stage 1. Cancer is spread only to the first two layers of rectal wall.
Stage 2. Cancer has spread to mesorectum, but lymph nodes are not affected.
For stage 1 cancer, surgery is the best treatment method available. Possibility of re appearance of cancer is rare for stage 1 cancer. In some cases of stage 1 cancer, after surgery the doctor may find that the cancer has spread to lymph nodes also. In such cases chemotherapy and radiation therapy are recommended.
For patients who are in stage 2 of rectal cancer chemotherapy and radiation therapy are suggested before surgery is performed. Chemotherapy and radiation therapy is also known as neoadjuvant therapy. Neoadjuvant therapy helps shrinking of the tumor. So the tumor can be completely removed in surgery. If neoadjuvant therapy is to be done after the surgery, consultation with an oncologist is unavoidable for ascertaining the necessity.
Stage 4 of rectal cancer is not curable. Chemotherapy and radiation therapy are the only treatments available for such patients. However average survival time of stage 4 patients have increased considerably over the years.
In sphincter sparing surgeries the laparoscope is inserted to the abdomen through a small incision in the abdomen and the instruments are inserted through other three incisions. The surgery is performed by viewing the interior parts of the patient through the monitor placed near the surgeon. The videos taken by the laparoscope are displayed in this monitor. In this surgery a small piece of the tumor or cancer inflicted portion of sigmoid colon is removed and the remaining parts are joined together either by stitching or stapling.
In some cases the rectum may also be damaged due cancer or tumor. In such cases the rectum is removed and an artificial stoma is attached to the end of the colon which is then stitched and fixed at the incision on the bottom left side of the abdomen. To this stoma a pouch is attached to collect the waste coming out of the stoma. As the stoma is not having any muscles they waste flow through it cannot be controlled. The pouch is periodically changed or cleared.
Dr.Kalpana in a panel on PCOS infertility Indian fertility society conference