The main way to cure a malignant tumor in the rectum is surgery. In the fight against tumors, current oncology combines few methods of treatment. In some cases, chemotherapy or radiation therapy may be given before the excision procedure to overcome the cancer. But the procedure to remove a malignant tumor is considered the most productive, albeit radical, method of curing this disease. Many patients are interested in what are the first symptoms of rectal cancer, survival after surgery, and what is the rehabilitation period to completely overcome the disease?
Varieties of operations
If the neoplasm is diagnosed at an early stage (I), has not grown through the wall of the inside and is located near the anus, local transanal resection or rectal cancer surgery with a laser is performed. During this procedure, no incisions are made on the skin: the doctor introduces devices through the organ. The incision is made through the entire thickness of the intestinal wall. Eliminate the affected area and materials close to it, the resulting deficiency is sutured.
Local transanal resection is performed underlocal anesthesia. During the procedure, the patient remains conscious. Since the lymphoid areas are not excised, a course of radiation therapy is performed after the intervention, in some cases in combination with chemotherapy, in order to eliminate the remaining cancer cells in the body.
If the neoplasm at stage I is located quite high in the rectum, then a method called transanal endoscopy is used. In fact, this is the same transanal operation, which is carried out with the support of the most labor-intensive equipment today, guarantees a significant reliability of the intervention.
Anterior resection
In the first three stages, when the neoplasm is located 10 cm above the anal sphincter, an anterior resection is performed. The procedure is performed by an open or laparoscopic method. The surgeon eliminates the tumor with the capture of a certain amount of he althy matter on both sides, as well as close lymphoid areas and surrounding tissue. Next, an anastomosis is applied: the end of the rectum is combined with the end of the colon.
The anastomosis is most severely applied immediately during the resection. But, if chemotherapy or radiation therapy was done before the procedure, the rectum needs a period to resume, otherwise standard healing will not happen. A temporary ileostomy is applied to the patient: an opening is made in the wall of the ileum (the final section of the small intestine) and injected into the skin. The ileostomy is usually covered and the anastomosis is applied after two months.
Low resection
The operation is performed when a tumor forms in the lower and middle parts of the intestinal tract. This method is called total mesorectumectomy and is a common method in medicine for removing a neoplasm directly in this part of the rectum. During this intervention, the doctor almost completely eliminates the rectum.
Hartmann procedure
Performed under the condition of bowel obstruction, as an urgent measure, perform the Hartmann procedure. Resection of the straight and sigmoid viscera is performed in the absence of anastomosis with the formation of a colostomy.
Proctectomy
In some cases, the entire rectum and the lymphoid areas around it should be removed. This procedure is called a proctectomy. It ends with the imposition of a colo-anal anastomosis - the end of the large intestinal tract is sutured to the anus.
Normally, the rectum acts as a container in which excrement accumulates. After proctectomy, this function will be performed by the final section of the colon. For this, the surgeon is able to form an unnatural J-shaped reservoir and perform an end-to-side anastomosis, which will help to reduce the frequency of defecation, guarantee the density of the stool, as close as possible to the standard.
Abdo-perineal surgery
The operation begins with 2 incisions - in the abdomenand perineum. The method is focused on the elimination of the rectum, areas of the anal canal and around the matter.
Local resection makes it possible to remove small tumors at the initial stage of the disease. For its execution, an endoscope is used - an instrument with a small camera. Such endoscopic surgery makes it possible to successfully fight neoplasms in the primary stages of the disease. If the neoplasm is located near the anus, the microendoscope may not be used by the doctor. Doctors remove a malignant tumor to a patient directly with the help of surgical instruments. They are inserted into the anus.
Transanal excision
In today's medicine, there are new methods of timely cure of the disease. They make it possible to preserve the sphincter of the organ, for this reason, radical measures are rarely used in surgery. One of these methods is considered transanal excision.
The method is used to eliminate small tumors that are localized in the lower part. For the execution of the operation, specialized equipment and medical devices are used. They make it possible to eliminate minor areas of the rectum and save the surrounding tissue. This procedure is performed without removing the lymphoid constructs.
Laparoscopy
The cancerous tumor is also removed with the help of open laparoscopy. With the laparoscopic method, the doctor makes a series of small incisions in the abdominal cavity. Then, an endoscope with a camera is inserted into them, which is equippedbacklight. Surgical instruments to pull out the tumor are inserted through other incisions. Such an operation differs from abdominal actions in the rapid recovery stage and the technique of performing surgical intervention.
After the procedure, a special stoma is created for most patients to remove bowel movements. By itself, it represents an artificial opening in the belly, to which a reservoir is attached to collect excrement masses. The stoma is made from an open area of the intestinal tract. The opening can be temporary or left permanently. A short-term stoma is created by doctors to heal the rectum after anal intervention. This kind of opening is covered by doctors after a few months. A continuous hole is needed only if the tumor was near the anus, low enough in the rectum.
If the tumor affects organs close to the rectum, extensive removal procedures are performed - pelvic exenteration, which includes the integral removal of the urinary bladder, including the genital organs.
Sometimes a cancerous tumor can form an obstruction in the intestinal tract, blocking the organ and causing nausea and pain. In such a situation, stenting or surgery is used. During stenting, a colonoscope is inserted into the blocked area, keeping the intestine open. With the surgical method, the blocked area is removed by the doctor, after which a short-term stoma is formed.
Abdomino-perineal resection
This type of surgical intervention is used in the first three stages, if the neoplasm is not high, grows into the sphincter (muscle pulp in the anus, is responsible for the preservation of fecal masses). The procedure is performed through incisions in the abdomen and in the anus. Since the anus will be removed, after the abdomino-perineal resection, a long-term colostomy is applied: the end of the colon is brought to the skin, a colostomy bag is attached.
It is allowed to take the end of the intestine to the perineum area. In fact, this is the same colostomy, but it is located in the usual area, where the anus was previously.
Pelvic evisceration
This is the most significant surgical intervention that is performed when the tumor grows into the surrounding organs. The rectum and organs of the urinary system are cut out. After the action, a colostomy, urostomy is applied (an opening in the anterior abdominal wall for urine diversion).
Preparation for surgery
Surgery for rectal cancer will require essential preparation. The day before surgery, an absolute cleaning of the intestinal tract from excrement masses is carried out. These actions are necessary in order to ensure that the enterobacterial content of the inside does not get into the peritoneum during the operation and does not provoke inflammation in the postoperative stage. In severe cases, when an infection enters the abdominal cavity, a dangerous complication may form, in the form of inflammation.
In preparation for constructive surgery, the doctor may prescribe specific pharmaceutical substances that givethe ability to clean the intestinal tract. It is impossible to refuse to accept these funds. It is important to clearly follow absolutely all medical advice - take the necessary amount of water, follow a diet for rectal cancer before surgery, etc.
Rehab
The operation requires the observance of absolutely all medical advice at the recovery stage. In some cases, chemotherapy is performed after rectal cancer surgery. It depends on the degree of the disease. The procedure makes it possible to improve the quality of life of patients and increases the percentage of survival in the disease. To date, doctors are focused on the implementation of organ-preserving methods and are trying to bring various multifunctional pathologies of the body to a minimum after the procedure. Interintestinal anastomosis makes it possible to preserve the continuity of the inside and sphincter. In this case, the stoma is not inserted into the wall of the intestinal tract.
The postoperative period of rectal cancer begins in intensive care. Under the supervision of staff, the sick person comes out of anesthesia. Medical supervision will make it possible to localize possible complications and prevent bleeding. On the second day after the operation, the doctor allows you to sit down.
After the operation, analgesics are required to relieve discomfort and pain. All ailments must be reported to the medical staff. Taking medication will make it possible to alleviate the situation. The doctor can determine the spinalor epidural anesthesia by injection. Painkillers are injected into the body with the help of droppers. A specially designed drain can be placed in the area of the surgical wound, which serves to drain excess water. After a few days, he is removed.
Eating is allowed three days after the procedure. The menu necessarily consists only of soups in the form of mashed potatoes and liquid cereals. The food is not greasy, s alty or oil-filled.
Survival rates for different stages of cancer
Many are interested in the question of how long they live after rectal cancer surgery. It is difficult to give an answer, because it all depends on the stage of the disease and the organism. There are four stages of cancer. Survival predictions below:
- I. At this stage, the malignant tumor only grows and does not have significant symptoms. It is easier to carry out surgical removal, and, accordingly, monitoring is preferable. How long do people live after rectal cancer surgery? The tumor at this stage has the most significant survival: more than 90%.
- II. A neoplasm at this stage is already more common, larger, capable of touching the surrounding organs of the genitourinary system. For this reason, approximately 75% of patients survive for 5 years after cure. Reviews of stage 2 rectal cancer surgery say that the recovery period is easy and life expectancy is increased.
- III. Only fifty percent of those who undergo the procedure at this stage survive the next five years. And all because for the thirddegree characteristic of the destruction of regional lymph nodes.
- IV. This stage has serious consequences. It is characterized by the occurrence of metastases in other organs. If the neoplasm has spread to a single organ, then the prognosis improves, but if in a pair, then this is a poor criterion. At this stage, only six percent of people can live five years.
At the first symptoms of rectal cancer, urgent treatment is needed, otherwise the consequences will be dire.
