Surgery may be necessary to treat bowel cancer. The aim of surgery is to remove the area of bowel affected by cancer and usually a small amount of healthy tissue either side, to ensure all the cancer cells are removed.
Lymph nodes near the bowel are usually removed as well. These are small bean-shaped organs that are part of your immune system. These are usually taken out because cancer tends to spread to the lymph nodes.
Bowel surgery for cancer usually requires a hospital stay of around ten days. It is done under general anaesthesia, which means you will be asleep during the procedure and will feel no pain.
Your surgeon will explain the benefits and risks of having bowel surgery, and will discuss any alternatives to the procedure.
About the operation
Your bowel is a long tube. Bowel surgery usually involves making a cut in the skin over the centre of your abdomen and removing the section of tube affected by cancer. The two ends are then joined together with stitches or staples. The amount of bowel removed depends on the position and size of the cancer and how advanced it is.
You will be given antibiotics during the operation to reduce the chance of getting an infection afterwards. The operation usually takes about two hours.
Colostomies and ileostomies
If the two ends of the bowel cannot be re-joined, you may need a colostomy or ileostomy. This is when one end of the bowel is joined to an opening in the skin (called a stoma). Waste can then pass from the bowel into a bag. The bag is worn over the stoma and lies against the abdomen.
Colostomies and ileostomies may be temporary, allowing the bowel time to heal after an operation. Once healed, the procedure may be reversed. This is called stoma reversal. However, in some cases a permanent colostomy or ileostomy may be necessary.
Your surgeon will discuss colostomies, ileostomies and stomas with you before the operation. Sometimes it isn’t possible for your surgeon to tell what is needed until the operation is under way.
After your operation, you may feel some pain, which can last for at least the first few days. Painkillers will help. Usually you will have a scar on the front of your abdomen. The exact size of the scar will depend on your particular operation.
A full recovery can take up to 12 weeks. You will need to take it easy and should expect to tire easily to begin with.
Bowel surgery is commonly performed and generally safe. However, all surgery carries an element of risk.
As with any type of surgery there is a risk of infection. This usually involves treatment with antibiotics but in rare cases further surgery may be needed.
Sometimes the join in the two ends of the bowel breaks down, or a hernia develops through the skin cut. Another operation will be needed if this happens.
Chest infections can occur after bowel surgery. You will be given advice about deep-breathing exercises to help prevent this. Other complications specific to bowel surgery include damage to other organs and structures in the abdomen, such as the stomach, although this is rare. During some types of bowel surgery the nerves responsible for sexual function may be damaged.
Serious complications of bowel surgery, including death, do occur. This risk is small, and is usually lower than the risk to life if surgery is not carried out.
The chance of complications depends on the exact type of operation you are having and other factors such as your general health. Ask your surgeon to explain how any risks apply to you.