Have you read part 1 ?

In the second part of my article, which is on surgical procedures, you will receive information on colectomy, low anterior resection, and abdoperineal surgery. Again, let me mention that this does not occur 100% of the time, and that sometimes cases we see are different than the ones we see in books. This is also why I would like to say again that asking questions to your health professionals is important.               

Pancolectomy, or total colectomy, is the removal of the entire colon. The rectum is also removed in certain cases. Subtotal colectomy is the removal of the entire colon, with the exception of the sigmoid, which stays in place. Partial colectomy is the removal of the parts of the intestine that are diseased. If a good portion of the colon is removed, it is possible to perform anastomosis to connect the two remaining parts of the intestines together. Otherwise, a stoma is needed. Surgeons decide if the resection is performed by laparoscopy or abdominal incision. The choice of the stoma being permanent or temporary is left to the medical team.

Low anterior resection is the total or partial exeresis of the rectum. Patients suffering from colorectal cancer undergo this type of surgery. Depending on where the tumour is located, part of the large lower intestine and sigmoid colon can be removed. After that, the parts left between the rectum and the colon are connected together. The digestive system then works again. If the rectum was removed all the way to the anus, the colon will be directly connected to the anus.  An ileostomy or a temporary colostomy can be created to prevent any leaks caused by the anastomosis, as it needs to be completely healed before the stoma is removed. A permanent stoma can also be created if the rectum does not have enough healthy tissues left.

Abdominoperineal surgery is the removal of the anus, rectum, and sigmoid colon. A permanent stoma is created, and the opening is located on the perineal level, which means a scar is visible there. After that, a colostomy is created with the sigmoid’s proximal region in the abdomen. This is considered a key treatment for colorectal cancer. Colostomy created after abdominoperineal surgery is permanent.

This is what concludes the second part of my article on stoma surgeries. I hope my complex words did not “traumatize” you too much. They will get you a lot of points in your Scrabble games, and you will remember me when you win! (haha!)

Véronique

Français

Reference: Vasilivsky, C., Gordon, P. (2004). Gastrointestinal Cancers: Surgical Management. In J.C. Colwell, M.T.Goldberg & J. Carmel (Eds). Fecal and Urinary Management Principles, St. Louis: Mosby Inc.(pp.126-135).