Colon and Rectal
Surgery
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When a diseased portion of the colon or rectum must be removed, that removal
is called a colon resection. Colon resection is performed for both benign and
malignant diseases. The need for a colon resection is usually determined by
findings during a colonoscopy or during any of several radiologic examinations of the colon such as a barium enema or CT scan. Because the
colon is by its very nature a contaminated organ, all elective colon resections are preceded by a thorough cleansing of the colon known as
bowel
preparation. This is done at home during the two-day period preceding
surgery. It usually involves a combination of a liquid diet and several oral
cathartics.
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The amount of colon removed depends on the extent of the underlying disease
process, but in many cases 1/3 or less of the colon's total length is removed. When operating for malignancy, a portion of colon containing the
tumor is removed along with the adjacent attachments which contain lymph
nodes. The microscopic examination of the lymph nodes is an essential part of
staging colon malignancies. All subsequent treatment is based upon this staging.
In the past all colon resections were done by way of sizable abdominal
incisions necessary for the proper exposure of the various attachments of the
colon. More recently, the surgeons at Montclair Surgical Associates have
begun to use the laparoscopic approach to colon resection for appropriate
indications. This method still requires an incision to actually remove the
colon but because the mobilization of the colon is all done
laparoscopically, the incision is much smaller. This results in less discomfort and better
cosmesis. Your surgeon will discuss with you which approach will be most
beneficial for your particular circumstance.
The removal of rectal tumors presents the additional challenge of not only
adequately removing the tumor but also preserving the function of the anal
sphincter which helps control our bowel habits. The surgeons at Montclair
Surgical Associates are all trained in the sphincter-sparing techniques which
will preserve sphincter function in all but the lowest of rectal tumor resections.
As with colon resection, rectal resection for tumor includes removal of the tumor as
well as adjacent lymph nodes. These nodes lie in a fat pad adjacent to the rectum
known as the mesorectum. A major advancement in rectal surgery has been the
development in Europe of a technique used to remove a rectal tumor along with the
entire mesorectum. This provides the greatest chance for removal of all adjacent lymph
nodes and has improved the short and long-term results of this surgery substantially.The technique is known as Total Mesorectal Excision (TME) and has become the
standard by which colorectal surgeons are credentialed in Europe. Dr. Robert
Barbalinardo took additional training in TME in England under the guidance of Dr. Bill
Heald, the world wide authority on this technique, and is pleased to be able to offer it to our patients.
The surgeons at Montclair Surgical Associates are well-trained and
experienced in the area of colon/rectal surgery. Their thorough evaluation of
your condition will help you decide what, if any, surgery might be appropriate for you.
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