Surgery for Rectal Cancer

Surgery for rectal cancer has advanced a great deal over the last decade. Ten to 15 years ago, if surgeons wanted to remove a tumor in the lower third of a patient’s rectum, they usually had to remove the anal sphincter muscle as well. To allow for the drainage of stool, they would then give the patient an ostomy, an opening to the abdomen where a bag collects solid waste.

Today, if the tumor does not directly involve the sphincter muscle or pelvic floor, surgeons at Siteman are frequently able to remove it while leaving these important structures intact, allowing patients to maintain normal bowel function. These are called “sphincter-sparing” procedures.

Some rectal cancer patients at Siteman will be treated with a procedure called transanal endoscopic microsurgical (or TEM) excision. Colorectal surgeons at Siteman helped pioneer this procedure, which allows for the removal of benign polyps and early cancers through the anus. The approach is minimally invasive and allows for better visualization and access to nearby lesions than traditional methods of rectal surgery. It is also being used in appropriate patients to remove more advanced cancers in conjunction with radiation therapy.

What if my cancer has spread?

If your cancer has spread to other organs in your body, surgeons might be able to perform a metastasectomy. A metastasectomy is a procedure to remove colorectal cancer from another organ, frequently the liver or the lungs. Surgeons at Siteman are skilled at these procedures and will try to find ways to eliminate rectal cancer from more distant areas.

Do rectal cancer patients ever need permanent ostomies?

Sometimes. Despite the new methods and techniques available today, a small percentage of patients will still need permanent ostomies due to the location and characteristics of their tumors. These patients will receive ongoing support from designated nurses and experienced enterostomal therapists.