Colon Cancer Surgery

Colon and rectal surgeons at Brigham and Women’s Hospital (BWH) are the surgical team for the Gastrointestinal Cancer Treatment Center at Dana-Farber Brigham Cancer Center, a unique center uniting the world’s best gastrointestinal cancer experts. Our board certified surgeons are leaders in colon cancer surgery, performing a large volume of colonoscopies as well as traditional and minimally invasive surgical techniques, including colectomy and colostomy.

Types of surgery include:

Partial Colectomy

Partial colectomy is the most common surgery to treat larger colon cancers, and it involves removing the part of the colon that has cancer, as well as a small amount of healthy tissue on either side. Nearby lymph nodes are also removed and checked for cancer. This surgery can be done through a single long incision in the belly (open colectomy) or by using long, thin surgical tools passed through many small, minimally invasive incisions in the belly (laparoscopic-assisted colectomy).

After removing the cancer, your surgeon has two options for completing the procedure. They may be able to reconnect the colon so that you can continue to pass bowel movements as you did previously, or you may need a colostomy bag.

  • If your colon is sewn or stapled together, that is referred to as resection of the colon with anastomosis.
  • If your colon cannot be reconnected, that is referred to as resection of the colon with colostomy. Your surgeon will make an opening (stoma) on the outside of your body to allow waste to pass through. A bag (colostomy) is placed around the stoma to collect the waste. This may either be temporary or permanent. If temporary, your surgeon will reverse the procedure as soon as your colon has healed. The risk of either a temporary or permanent colostomy is rare for colon cancer patients.
Local Excision

Local excision removes early-stage (Stage 0) colon cancer by placing a tube through the rectum into the colon. It does not require an incision and is often done during a colonoscopy. It is done without cutting through the abdominal wall.

  • If the early-stage colon cancer is found in a polyp, the procedure is referred to as a polypectomy.
Palliative Surgery

Palliative surgery is surgery to help relieve symptoms, such as bowel impactions or blockages, for patients with more advanced, incurable colon cancer (Stage IV).

Our center also has special expertise in cytoreductive surgery (CRS), which may be advised for certain patients with Stage IV metastatic colon cancer to the peritoneal cavity. This procedure removes all of the visible disease and is immediately followed by hyperthermic intraperitoneal chemotherapy (HIPEC), which uses heated chemotherapy in the abdomen, the same day as CRS. Read about how one of our colon cancer surgeons, Nelya Melnitchouk, MD, MSc, director of the Program in Peritoneal Surface Malignancy within the Division of Gastrointestinal Surgery, pioneered a new enhanced recovery pathway for patients receiving CRS and HIPEC here at Dana-Farber Brigham Cancer Center.

Learn more about these surgical treatment options and all of our center’s treatment options.

If you are having surgery or a procedure, you will likely be contacted for preoperative information and tests. Learn more about planning for preoperative appointments, as well as contact information for the Weiner Center.

Before Surgery

In advance of your surgery, we recommend planning ahead for your surgery including designating someone to bring you to and from your procedure. Make sure you have enough food and supplies at home post-surgery. We also recommend that someone helps you with labor-heavy tasks immediately post-surgery, such as grocery shopping, cleaning and laundry. You can also prepare for surgery by eating a high-protein diet, exercising, limiting alcohol and abstaining from smoking. Your care team will provide you with specific instructions to best prepare for your surgery, including what to do the night before your scheduled surgery. These instructions will also be in your patient journey guide if you received one. Also ask your doctor any questions about your upcoming surgery.

The Day of Surgery

The day of surgery, you will be asked to have a carbohydrate supplement drink two to three hours before your surgery. This drink ensures consistent sugar levels in your blood during surgery, which allows you to recover and heal faster.

You will be cared for in the operating room by our surgeons, anesthesiologists and nurses who specialize in colon cancer surgery. After surgery, you will recover in the post-surgical care unit where you will receive comprehensive care by our experienced surgical and nursing staff. Your hospital stay will depend on the type of surgery you have. The average patient will be in the hospital for three days.

You will likely experience pain for the first few days after surgery, but your care team will work with you to reduce your pain through both narcotic medicine and non-narcotic pain control. Talk with your care team about your options for pain relief.

After Surgery

Recovery time after you leave the hospital varies from patient to patient, but it may take a month or more. You may feel tired or weak immediately post-surgery. You may have more frequent bowel movements at first, but that should return to normal in time. You may also have some pain. Talk with your doctor about pain management.

Our surgeons are advocates of an Enhanced Recovery After Surgery (ERAS) protocol which uses the latest evidence-based methods to help you heal sooner than ever. The ERAS pathway improves and quickens your recovery post-surgery, shortens the length of your hospital stay, minimizes any pain you may have and reduces any possible complications. Our nurses and care team will work with you to help you begin eating, getting out of bed, sitting and walking the same day as your surgery. We will minimize narcotics, focusing primarily on non-narcotic pain control. Eating will first consist of a special carbohydrate drink to help your nutrition.

If you have any questions about your surgery, talk to your health care team. They can help you know what to expect before, during and after your surgery. Learn more about your hospital stay and returning home.

Learn more about treatment options for colon cancer.

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