Complex Colorectal Resection | Pristyn Care

Risk Factors

Risk factors for requiring resection:

• Family history of colorectal cancer or FAP/HNPCC
• Long-standing inflammatory bowel disease
• Obesity and sedentary lifestyle
• Age over 50 years
• Previous pelvic radiation
• Chronic diverticular disease

Who Is at Risk

Individuals over 50, those with a family history of colorectal cancer or inflammatory bowel disease, and patients with long-standing colonic polyps or diverticular disease are most at risk of requiring colorectal resection.

Diagnosis

Pre-operative workup includes:

• Colonoscopy with biopsy for tissue diagnosis
• CT chest-abdomen-pelvis with contrast for staging
• MRI pelvis for rectal cancer (T and N staging, CRM assessment)
• PET-CT for metastatic workup in select cases
• Multidisciplinary team (MDT) discussion for treatment planning
• Carcinoembryonic antigen (CEA) baseline level

Treatment: Complex Colorectal Resection

Pristyn Care performs laparoscopic and robotic-assisted colorectal resections with total mesorectal excision (TME) for cancer, following ERAS protocols for faster recovery and optimal oncological outcomes.

Procedure

Surgical procedure involves:

• Pre-operative bowel preparation and ERAS optimisation
• Laparoscopic or robotic approach with 4-5 ports
• High vascular ligation for oncological clearance
• Complete mesocolic or total mesorectal excision (CME/TME)
• Bowel anastomosis (hand-sewn or stapled) or stoma formation
• Diverting loop ileostomy for low rectal anastomosis
• ERAS protocol: early feeding, mobilisation, multimodal analgesia

After the Surgery

Post-operative care includes:

• ERAS protocol: early oral fluids and diet
• Stoma care education if stoma formed
• Physiotherapy and early ambulation
• Adjuvant chemotherapy or radiotherapy as per oncology plan
• CEA monitoring and surveillance colonoscopy
• Psychological support and colorectal cancer nurse specialist input

Possible Complications of Colorectal Resection

Potential complications:

• Anastomotic leak (most serious complication, 3-10%)
• Wound infection and intra-abdominal abscess
• Urinary or sexual dysfunction after pelvic dissection
• Bowel obstruction due to adhesions
• Stoma complications (prolapse, retraction, hernia)
• Oncological recurrence