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Illustrations for Bowel resection for colorectal cancer

Posted by jpluimers on 2022/06/24

I finally found some great illustrations having to do with my lower anterior resection.

They are from [Wayback/Archive] https://www.uvmhealth.org/healthwise/topic/zm6206 (Bowel resection for colorectal cancer)

The most important for me is this one (as I have end-to-side where “end” is on the very tiny bit of rectum left and “side” is on the descending colon):

The end-to-end surgery has the drawback of scar tissue likely to contract over time making the bowel narrower than planned.

The second most important one is because I have both types of scars: laparoscopic surgery was used during lower anterior resection (with a ~7 cm horizontal scar to take out the removed bits) leaving an ileostomy and open surgery was done during the combined operation to

  1. remove liver metastases
  2. closing the ileostomy
  3. end-to-side reconnection of descending colon to tiny bit of rectum

followed by extending the open surgery scar because of emergency surgery as the ileostomy closure leaked. That surgery required a new ileostomy on the left side of my belly button (next to where the descending colon is).

Comparison of laparoscopic surgery scars and open surgery scar

 

Quoting in the order of appearance as it helps me explain to other people what kind of surgery I had :

  1. Anatomy of the colon and rectum

    The colon and rectum and where they are in the body
    The colon and rectum are the last parts of the bowel (intestine). The bowel extends from the opening where food leaves the stomach to the opening where feces leave the body (anus). The bowel helps to process food, absorb nutrients and water, and get rid of waste.
  2. Colon cancer site

    Cancer in the wall of the descending colon
    Cancer is shown in a section of the descending colon.
  3. Bowel section removed

    Section of colon removed
    Resection is another name for any operation that removes tissue or part of an organ. Bowel resection, also called partial colectomy, for colorectal cancer removes the tumor and part of the colon or rectum around the tumor. Both ends of the bowel section being removed are stapled and cut. Nearby lymph nodes, lymph drainage channels, and blood vessels are also removed.
  4. Bowel reattached

    Ways the cut ends of the colon may be reattached
    The remaining ends of the bowel are reattached, either end-to-end, side-to-side, or side-to-end.
  5. Surgery scars

    Comparison of laparoscopic surgery scars and open surgery scar
    If you have laparoscopic surgery, you will have 3 to 6 small scars. An example is in the picture on the left. Your surgeon may make 1 or 2 of the small openings a little bigger to allow space to complete the procedure. If so, those scars will be a little longer than the others. If you have an open resection, you will have one long scar. An example is in the picture on the right.
Medical Review:E. Gregory Thompson MD – Internal Medicine & Kathleen Romito MD – Family Medicine & Kenneth Bark MD – General Surgery, Colon and Rectal Surgery

Moar pictures

  • [Wayback/Archive] Low anterior resection

    End-to-side anastomosis between the rectum and the colon.

  • [Wayback/Archive] Colonic J-pouch versus side-to-end anastomosis for rectal cancer: a systematic review and meta-analysis of randomized controlled trials | BMC Surgery | Full Text

    Results

    Nine articles incorporating 7 trials with a total of 696 patients (330 by J-pouch and 366 by side-to-end) were enrolled in this meta-analysis. The bowel functional outcomes were comparable between J-pouch and side-to-end groups in terms of stool frequency, urgency, and incomplete defecation at the short term (< 8 months), medium term (8–18 months), and long term (> 18 months) follow up evaluations. No difference was observed between groups with regards to QoL (SF-36: physical function, social function, and general health perception). Besides, surgical outcomes were also similar in two groups.

    Conclusion

    The currently limited evidence suggests that colonic J-pouch and side-to-end anastomosis are comparable in terms of bowel functional outcomes, QoL, and surgical outcomes. Surgeons may choose either of the two techniques for anastomosis. A large sample randomized controlled study comparing colonic J-pouch and side-to-end anastomosis for rectal cancer is warranted.

    Fig. 1

    figure 1
    Side-to-end (A) and colonic J-pouch anastomosis (B)

Via

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–jeroen

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