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Bowel Cancer Surgery

Introduction

Many types of bowel cancer require surgery to remove the tumour or tumours and sometimes an affected section or sections of the bowel must be removed. Surgery is sometimes combined with other treatments to maximise the chances of a successful outcome - cancer of the rectum for example generally responds well to chemotherapy and radiotherapy treatment before surgery. In contrast colon cancer (carcinoma) does not respond to radiotherapy ahead of surgery.

Preoperative Instructions

You will be provided with full instructions on how to prepare for surgery well in advance of the procedure.

Procedure

Surgery to the bowel can be conducted using two different approaches - keyhole surgery, otherwise known as 'minimally invasive' surgery or 'laparoscopic' surgery, or by conventional 'open' surgery. Laparoscopic surgery entails making a small number of very small incisions to the skin to allow special laparoscopic medical instruments access to the bowel.

Open surgery is a more traditional approach where a larger incision is made to allow direct access to the bowel to the surgeon. There are advantages and disadvantages to each approach and your doctor will discuss this with you before surgery.

If a section of bowel needs to be removed, the two remaining sections will be joined together in a process known as 'anastomosis'. If the anastomosis procedure is not an option, you may need to have a colostomy, which can be either temporary or permanent.

Postoperative Instructions

Most operations involving bowel surgery require a hospital stay of around 5-7 days, sometimes a little longer in the case of elderly patients or patients who do not have help at home.

Food Requirements

After the procedure you may need to follow a specific eating regime, for example you may need to minimise your fibre intake for 8-10 weeks, and you will be advised if there are special dietary requirements. In all cases it is advisable to eat smaller portions than usual and ensure all food eaten is well chewed. You should avoid taking laxatives before speaking with your surgeon, who will advise whether they can be taken or not.

Wound Care

Generally, any dressings can be removed five days after the procedure. Any staples remaining are removed 7-10 days after the procedure.

If you have been fitted with a colostomy

You will receive instruction and guidance in how to look after a colostomy from a specialist nurse, as well as 'community stoma therapists' who will be able to help you at home.

Longer Term Recovery

You are encouraged to be moderately active once you return home - taking regular walks and being active around the house is a good idea although more strenuous exercise for example strength exercises, sport, going to the gym etc. should not be undertaken until at least a month after the procedure. This period is longer where the procedure was carried out using open surgery.

Driving or Operating Heavy Machinery

You should avoid either of these activities for 3 weeks after surgery, or for 5 weeks if the surgery was open surgery.