Laparoscopic or open surgical treatment of cancers, polyps, diverticular disease and inflammatory conditions affecting the colon and rectum.
Indication
- Surgical treatment of colon and rectal cancer (colorectal carcinoma)
- Large or high-risk polyps that cannot be removed endoscopically
- Complicated diverticular disease (perforation, abscess, bleeding)
- Inflammatory bowel disease (Crohn's, ulcerative colitis) refractory to medical therapy
- Recurrent bowel obstruction or ischemic colitis
- Rectal prolapse and severe sphincter problems
Preparation
- Preoperative complete blood count, biochemistry, coagulation tests and tumor markers
- Chest X-ray, ECG and, if needed, cardiac/pulmonary function evaluation
- Imaging: CT, MRI, full colonoscopy and pelvic MRI for rectal cancer
- Liquid diet for 24-48 hours before surgery and bowel preparation with an oral solution
- Fasting for at least 8 hours before anesthesia; adjustment of blood thinners
How it's performed
- The patient is positioned on the operating table under general anesthesia
- In laparoscopic surgery, the camera and instruments are placed through small incisions; open surgery is preferred when appropriate
- The diseased colon or rectum, together with its feeding vessels and regional lymph nodes (in rectal cancer following the principle of total mesorectal excision, TME), is removed
- The two ends of the bowel are joined with the appropriate technique (anastomosis); a temporary stoma may be required in some cases
- The abdominal cavity is irrigated, hemostasis is checked and a drain is placed if needed
- Incisions are closed; the resected specimen is sent to pathology
Post-procedure
- Intensive care or surgical ward follow-up for 3-7 days
- Early mobilization, breathing exercises and gradual return to oral intake
- Stoma care education and nursing support for patients with a stoma
- Planning of chemotherapy/radiotherapy with oncology based on pathological staging
- Follow-up with regular surveillance colonoscopy, CT and tumor markers for the first 5 years
Risks
- Anastomotic leak (leakage at the bowel join) — a serious complication
- Wound or intra-abdominal infection or abscess
- Bleeding and need for transfusion
- Bowel obstruction, ileus or adhesions
- Temporary or permanent injury to ureters, bladder or pelvic nerves
FAQ
Is colorectal surgery performed laparoscopically or open?
The choice depends on the patient's condition and the extent of the disease. In suitable cases the laparoscopic approach allows smaller incisions, less pain and faster recovery, with oncological outcomes considered equivalent.
Is the stoma (bag) permanent?
In most cases the stoma is temporary and is closed after a few months; it may be permanent in very low-lying rectal tumors. The decision is shared with the patient before surgery.
When can I return to my normal life after surgery?
Most patients can return to daily activities within 2-4 weeks; return to heavy work and sports may take 6-8 weeks.
Will I need chemotherapy?
The need is determined by the pathological stage, lymph node involvement and molecular features. The decision is made by a multidisciplinary tumor board.
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