Cancers of the colon and rectum are two of the most common cancers in the United States. Together, they are referred to as colorectal cancer. The colon and rectum form the large intestine, the lower end of the digestive tract.
Surgical removal of a malignant tumor is the most common treatment for colorectal cancer. The diseased portion of the colon and/or rectum is removed, and in most cases, the healthy portions are reattached. Sometimes, that is not possible because of the extent of the disease or its location. In that case, a surgical opening is made through the abdomen to provide a new path for waste elimination. This is known as a colostomy.
A colostomy may be made as a temporary measure, to allow more time for the colon or rectum to heal. After a period of time, the intestine can be reattached and the colostomy closed. However, about 15 percent of patients with colorectal cancer have a permanent colostomy.
A colostomy also may be performed to treat traumatic injuries to the bowel, diverticulitis, and inflammatory bowel disease, when other treatment measures fail.
Types of Colostomy
Colostomy is performed under general anesthesia (i.e., the patient is rendered unconscious). After the anesthesia has taken effect, the abdomen is cleaned with an antiseptic solution. A catheter may be inserted into the bladder to measure the amount of urine being produced and to make sure the patient remains well hydrated.
An incision is made in the abdomen and the affected part of the colon and/or rectum is located. The surgeon clamps the colon on both sides of the diseased portion and then removes it. One end of the colon is then brought out through a separate incision in the abdomen and sutured in place. The other end remains clamped off. This procedure is done very carefully to avoid injury to organs that are located close to the colon. Operating time is about 3 hours but varies depending on the extent of disease and the amount of intervention needed.
When the surgery is completed, the patient has an ostomy and a stoma. The ostomy is the opening created in the abdomen, and the stoma is the end of the colon that protrudes through the skin.
In some selected cases, laparoscopy may be an option in colon cancer surgery.