Sphincter-Saving Techniques for Rectal Cancer

Based in Valley Stream, New York, Dr. Rajiv Datta serves as chair of the department of surgery at South Nassau Communities Hospital. Among his areas of focus is providing diagnosis, screening, and treatment of colorectal cancers. Dr. Rajiv Datta emphasizes that with appropriate sphincter-saving techniques in place, it may be possible to avoid permanent colostomy.

According to the American Cancer Society, one major factor in determining the surgical approach is the nearness of the tumor to the anus. Another factor is whether the cancer has reached the sphincter muscles that encircle the anus and prevent stool from being released until they relax, when bowel movements occur. 

Most polyps and early rectal cancers may be removed during a colonoscopy, in which a small flexible tube with a camera is threaded via the anus into the rectum. One such procedure is a polypectomy, which employs a wire loop and electric current to remove the polyp from the rectum’s wall. 

Another type of colonoscopy procedure, local trans-anal resection, is employed in cases where early-stage rectal cancers are situated near the anus and are fairly small. This procedure involves the insertion of a scope through the anus, a cut through the rectal wall, and removal of the cancer. A certain amount of unaffected surrounding rectal tissue is also removed. Because lymph nodes remain in place, in cases where the tumor has progressed deep within the rectum, follow-up radiation and chemotherapy may be recommended.

Advanced surgery may involve the creation of a pathway to the outside of the abdomen, such that waste avoids the rectum when exiting the body. The patient wears a colostomy bag to collect the waste. This may be a temporary requirement to give the colon time to heal after surgery, or permanent if extensive surgery is needed.