Colorectal cancer, also known as rectal, bowel or colon cancer, refers to malignant tumors that develop in the large intestine. In Singapore, it is the most common cancer among men and the third most common cancer among women. Though common, colorectal cancer in its early stages is very treatable via surgery, chemotherapy and radiation therapy. When detected early, colorectal cancer poses a survival rate of up to 80% to 95%. Left untreated, however, the cancer can invade nearby lymph nodes and other organs like the liver.
Colorectal surgery may be done traditionally (open surgery) or laparoscopically (minimally invasive). Here, instead of creating a long incision across the abdomen to access the organs, small incisions are made, through which a laparoscope (a small light and camera that transmits clear images to a viewing screen outside) and other microsurgical instruments are inserted. This results in minimal pain and bleeding after surgery and a significantly faster recovery.
Depending on the severity and location of the cancer, there are several types of colorectal surgery in Singapore a doctor may choose from, some of which include:
A partial colectomy is a surgical procedure where the cancer-affected segment of the colon and a portion of surrounding healthy tissues are removed. The remaining parts of the colon will then be stitched back together using a technique called anastomosis. As the organ heals, a temporary colostomy is done to allow waste to be expelled from the body. In some cases, the colostomy is permanent.
An ileocolectomy involves removing a portion of the ileum that has turned cancerous. The remaining parts of the small intestine are re-joined using staples and stitches. Similar to a partial colectomy, a temporary or permanent ileostomy may be required after surgery to re-route the flow of waste from the intestine to an artificial opening (stoma) on the abdominal wall and into a collection bag.
This form of colorectal surgery is specifically done to treat anal cancer. Abdominoperineal resection involves removing the rectum, anus and a portion of the sigmoid colon through a keyhole incision on the abdomen. A stoma is then created on the abdomen, to which the end of the intestine is attached. This is done to facilitate the passage and subsequent collection of wastes into a disposable bag.
This is a procedure performed to remove colorectal tumors and polyps, and it refers to the partial or complete removal of the sigmoid colon and rectum. For partial resections, an anastomosis is done to rejoin the remaining organs to regulate function. Proctosigmoidectomy may be done via open or laparoscopic surgery.
A total abdominal colectomy removes the large intestine completely. Once this is done, the small intestine will be connected straight to the rectum. Apart from colorectal cancer, this technique is typically performed to treat Crohn’s disease and severe motility disorders such as colonic inertia.
Total proctocolectomy is the complete removal of the large intestine and rectum. It always involves the creation of an ileostomy or ileal pouch anal anastomosis to regulate bowel movements. This method is typically performed to treat colorectal cancer and ulcerative colitis.
The type of colorectal surgery recommended to a patient depends on the stage of his or her condition, as well as the location and extent of the cancer. As with all medical operations, each of these methods come with a set of risks, but in the hands of a skilled and qualified colorectal surgeon, such procedures are safe and effective in dealing with colorectal cancer.
Ho Kok Sun Colorectal is a well-established colorectal surgery center in Singapore offering a comprehensive list of diagnostic and treatment services including colonoscopy for the management of various colorectal conditions. To schedule an appointment with consultant colorectal surgeon Dr. Ho Kok Sun, call 6737-2778.