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When is a colostomy required for colon cancer surgery?

Colorectal Surgery Surgical Oncology General Surgery

My dad is refusing to go for surgery because he does not want to have a "poop bag". When is a colostomy required after colon cancer surgery? Is it possible to avoid having one?  

DOCTOR’S ANSWER (1)

There are 2 types of colostomy : temporary and permanent. 

During colorectal cancer surgery, the segment of bowel containing the cancer is removed and healthy bowels are joined back together to form a joint, or what surgeons call an anastomosis. For cancers that are near the anus muscles (so called low tumours), the chance of leakage after the anastomosis is formed is higher than cancers that are further away from the anus (high tumours).

Therefore, temporary colostomies are created after operation for low tumours to divert the fecal stream away from a fragile anastomosis to give it a better chance to heal. Colostomies are frequently not necessary after operation for a high tumour.

Temporary colostomies are closed at a later date once the anastomosis is deemed to have healed using special X rays. This varies from 1-3 months after the operation.

Permanent colostomies are created when the tumour is so low it involves the anal muscles. The anus is therefore sacrificed during the operation and the remaining colon is brought out on the abdomen as a "new anus". The bottom end is then closed permanently. The patient then lives with the stoma for the rest of his/her life.

A colostomy, whether temporary or permanent, is easy to manage, odourless, hides easily under clothings, and has negligible impact on quality of life. The patient is able to continue his or her way of life with no fuss. There are quite many prominent public figures with a permanent colostomy and they carry on their public functions without anyone knowing. I have many patients with permanent colostomies and no one has ever come back and say they regretted their operation. 

You should contact the Ostomy Association of Singapore. They will send someone who lives with a colostomy to visit your dad and show him it isn't something to be afraid of.

426 views 23 Nov 2018
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