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“I
received fantastic care from Dr. Larson. He explained
the surgery in detail even though I’m
a nurse. Some doctors (if they know
you’re a nurse) don’t explain things as well.”
—Kay
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Consisting of the terminal three to four feet of the GI
tract, the colon and rectum function mainly to reabsorb water and store
waste.
Colorectal cancer is common - it will be diagnosed in nearly 200,000
patients in the U.S. this year. Colorectal cancer is the second most
common cause of cancer death (lung cancer is first).
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There are both benign and malignant colon diseases that
require
surgery. The benign problems include polyps (which can be precancerous),
diverticular disease (causing bleeding or infection), colitis, and
obstruction. These diseases are usually treated non-operatively if
possible, but sometimes surgery is needed for definitive treatment in
severe cases.
Colorectal cancer usually requires surgery. Occasionally, a colon cancer
may be small and located entirely within a polyp, and complete removal
of the polyp can be performed with a colonoscopy.
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Colon diseases that require surgery are usually treated
with removal of the offending section of bowel, whether it’s for cancer,
bleeding, infection, or obstruction. Most commonly, just a segment of colon
needs to be removed, and the remaining large intestine can be
re-connected. Colon resections can be performed laparoscopically or
with an open technique. Colon cancers, unless they're very early, should
generally be resected with an open technique in order to fully remove
all the cancer. For non-cancer colon surgery, however, I
use a minimally invasive, laparoscopic technique whenever
possible (emergency operations for obstruction or bleeding usually
require an open approach).
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Colon surgery is usually safe and effective.
Antibiotics and a pre-op bowel prep are important in keeping infection
rates low. Colon cancer staging is based on whether the cancer has
spread through the bowel wall, to the lymph nodes, or to other organs.
If the lymph nodes don’t contain any cancer cells, surgery gives an
approximate 75% cure rate. If there is lymph node or liver involvement,
chemotherapy (and sometimes radiation therapy) is recommended to improve
the chance of being cured. Colon function after surgery is usually not
very different than before surgery. The stools might be more frequent or
more loose, but your body usually establishes a new equilibrium within a
few weeks after surgery.
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Your risk of developing colon cancer is a combination
of genetic and environmental factors. The traditional Western diet, high
in red meat and fat and low in fiber, is thought to increase the
risk of colon cancer. A first-degree relative such as a parent,
sibling, or child with colon cancer increases your risk. The American
Cancer Society recommends that asymptomatic people over the age of fifty
have their stool checked for occult blood yearly, and that screening
colonoscopy or sigmoidoscopy be performed regularly. People with
increased risk factors should have these tests done sooner and/or more
frequently - ask your doctor what's appropriate for your situation.
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