What is proctectomy?
The surgery which is performed for the removal of all parts of the rectum is known as proctectomy. It is performed as a treatment of rectal cancer. The treatment for rectal cancer is decided after determining with stage and extension of cancer in your rectum. Most people with rectal cancer are treated with a proctectomy. It can also be considered an option for the treatment of inflammatory bowel disease.
Proctectomy can be performed by different methods. The type of proctectomy is dependent on the:
- Location of the cancer
- Extension of the cancer
The large bowel or intestine which comprises the rectum and colon is referred to as the last portion of the digestive system. The rectum and anus involve the last 6 inches portion of the digestive system. A proctectomy may remove all the parts of the rectum or it may also include the anal area in some rare situations.
Factors that lead to proctectomy
Typically, proctectomy is used for treating rectal cancer. Once you are diagnosed with rectal cancer the next step is to determine the stage of cancer and if it has outgrowth into other regions than the rectum. Different types of proctectomy are used for treating different stages of rectal cancer.
Some inflammatory bowel diseases can also be treated with the help of proctectomy, such as:
- Ulcerative colitis: Infection or ulcers in the colon
- Crohn’s disease: Discomfort and soreness in the colon
Almost all surgeries have some risks and complications. The complications associated with proctectomy are:
- Blood loss
- Infection at the incision
- Internal abdominal infections
- Any fatal blood clot in the leg or arm which moves to the lungs
- Difficulty in urination
- Difficulty in bowel movements
- Delay in wound recovery
- Intimacy issues
- Anesthesia can damage the heart or brain
Other risks might be there depending on the health condition of the patient. You can discuss all the possible risks with your doctor before this surgery.
What happens before the procedure?
You will be examined thoroughly before the procedure. This helps mark the stage and plans the whole surgery. You may undergo blood tests, x-rays, and EKG. A colonoscopy might be done. It is a procedure that allows the surgeon to examine the colon and the rectum. A tiny camera, light scope, and a flexible tube is used for this purpose.
The things that you may need to know before the surgery are:
You should thoroughly cleanse your bowel. It must be empty. You may need to make some changes in your diet and you need to follow all the instructions.
Your doctor will recommend you prepare your bowel before the surgery. It means you need to take enemas or laxatives.
Your doctor will tell you to stop eating or drinking anything 12 hours before the surgery.
You should discuss your medication such as vitamins, supplements, or antibiotics you have been consuming. He or she might tell you to stop taking some specific medicines some days before the procedure. Especially the blood-thinning medicines are prohibited.
What happens during the surgery?
Following events can take place during the surgery:
You will be given anesthesia; you will be asleep during the entire procedure.
Your surgeon might perform invasive laparoscopy. In this method, small incisions are made in the abdomen. The surgeon inserts some tools and sees the process on a screen.
Your surgeon might perform local resection of the anus. This is done to prevent cancer that may enter through the anal orifice and has not spread too far. In this method, there is no need for an incision.
Cancer which is severe and deeper in the rectum then another method is required. N incision is made in the lower abdomen and a relatively large part of the rectum is removed. This is termed low anterior resection (LAR).
If the healthy tissues in the rectum remain in a large number then they can be connected back. This process is known as anastomosis. You can pass out bowel movements through the anus normally. The frequency of the bowel movement will be altered after the process. This also changes the consistency of the feces.
In case if your rectal cancer is very severe and it is around the anus, you may undergo abdominoperineal resection. In this procedure, the anal opening is closed and the rectum is removed out. The other terminal of the colon is brought to the abdominal wall resulting in an opening that results in a stoma. This is known as colostomy. Then the feces are collected outside the body in a collecting pouch.
In some rare cases, a surgery termed pelvic exenteration is required. In this procedure, the surrounding parts or organs are removed such as the bladder, prostate, uterus. Typically a colostomy is required following this procedure.
What happens after the procedure?
You need to be admitted to the hospital for few days following the surgery. Once you are discharged, ensure that you must follow all the instructions regarding your diet, physical activities, and daily care routine.
The following tips may help recover faster:
You should start mild walking as soon as you can.
You should turn back to your normal life activities after some weeks of the surgery. Your doctor will tell you exactly when you should get back to bathing, swimming, and driving. You should avoid lifting weights for more than six weeks.
You should observe your wound closely and if you feel any changes or something weird you can call your doctor.
When to see your doctor or healthcare center
- If you are having a high fever
- If you experience swelling, rashes, blood, or leakage
- Worsening pain
- Breath shortage