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What Does Colorectal Cancer Surgery Actually Entail?

While there are different types of colorectal surgery available in Singapore (depending on the stage and extent of the cancer), the main goal of colorectal cancer surgery remains the same – to remove the cancerous sections of the colon and/or rectum, as well as its surrounding tissues and lymph nodes, before stitching the remaining two ends back together.

What Are the Colorectal Cancer Treatments Available?

At our Colorectal Surgery Clinic, we are skilled in both open and laparoscopic methods of surgery, including the use of advanced robotic surgery which offers high levels of precision, speed and safety. We also offer non-surgical therapies like chemotherapy and radiation therapy so as to provide personalised, all-rounded care.

There are three main types of surgery for colorectal cancer. These include:

• Open Surgery

  - This traditional method involves making a larger incision in the abdomen to access the colon or rectum. It is typically used for complex cases where a good view of the surgical area is necessary.

• Laparoscopic Surgery

  - This is a minimally invasive procedure that only needs small incisions and a tiny camera to remove the tumour. This method often results in less pain, smaller scars and faster recovery compared to open surgery.

• Robotic Surgery

  - This is an advanced form of minimally invasive surgery. The surgeon sits at a console and controls robotic arms to perform the surgery precisely and accurately.

Non-surgical therapy treatments are often used in combination with surgery for advanced cases of colorectal cancer. These include:

• Chemotherapy

  – This treatment uses powerful drugs to slow or stop tumour growth. It is often recommended after surgery to eliminate any remaining cancer cells and reduce the risk of recurrence.

• Radiation Therapy

  – This treatment uses high-energy radiation to destroy cancer cells. It can be given to relieve symptoms of advanced colorectal cancer.

• Immunotherapy

  – This treatment uses the body's immune system to target and destroy cancer cells. It can be given to help control advanced colorectal cancer and improve long-term outcomes.

How to Prepare for Colorectal Surgery

Preparing for colorectal surgery is crucial for a smooth procedure and optimal recovery.

• Bowel Cleanse – Patients need to undergo a liquid diet for a few days before surgery. Laxatives may also be prescribed. This ensures that their bowels are empty and thoroughly cleansed.
• Lifestyle Changes – Smoking and drinking alcohol should be avoided in the weeks leading up to surgery as they can impair wound healing and increase the risk of complications.
• Medication Adjustments – Some medications, such as blood thinners, may need to be adjusted or stopped before surgery to reduce the risk of excessive bleeding during and after the procedure.
• Fasting – Patients must not eat or drink anything for a certain period before surgery. This is essential to ensure the procedure is safe and effective.

What to Expect After Colorectal Surgery?

Recovery after colorectal surgery depends on the procedure and individual factors. Many colorectal cancer cases are curable, and minimally invasive techniques like laparoscopy and robotic surgery can promote faster recovery, reduce infection risk, and minimise scarring.

Generally, here is what you can expect after the procedure:

• Following colorectal surgery, patients typically remain in the hospital for a few days while their vital signs are closely monitored. Pain medication will be prescribed to manage post-operative discomfort.
• Initially, patients will receive clear liquids intravenously to allow their digestive system to adjust. This will gradually transition to soft foods and then a balanced, high-fibre diet.
• Temporary changes in bowel habits are common during the recovery period. These usually resolve with dietary adjustments or medication.
• Strenuous activities and heavy lifting should be avoided for several weeks as advised by your surgeon.
• Follow-up appointments with your surgeon are crucial to monitor healing, assess bowel function, and address any concerns, including signs of infection or complications.

FAQs on Colorectal Cancer Surgery

I’m not keen on colon cancer surgery. Are there non-surgical treatments available?

• When it comes to colorectal cancer, surgery provides the best chance of cure. Non-surgical treatments such as chemotherapy and radiation therapy are better used as supporting treatments, as well as to prevent recurrence, but not as the primary cure.

Am I going to end up with a stoma after colon cancer surgery?

• In most cases, a stoma is not needed. However, when a large portion of the colon has been removed and cannot be immediately reattached, a temporary or permanent stoma may be required. Nevertheless, having a permanent stoma is very unlikely.

Does having colorectal cancer mean that I am likely to die?

• Not true. When colorectal cancer is detected early (usually through routine colonoscopies), the chances of survival actually exceed 90%!

If my cancer has metastasised (spread), does that mean I have a short life expectancy?

• With the rapid advancements in medical knowledge and technology, the prognosis of colorectal cancer has improved significantly. For example, in the 1990s, the survival rate for stage 4 colorectal cancer was just between 6 to 8 months. Today, it stands at around 30 months – 5 times more.