Rectal Cancer Surgery in India

Rectal cancer surgery removes the cancerous section of the rectum, the final part of the large intestine, along with surrounding lymph nodes, to treat the disease and reduce the risk of it spreading or returning. The specific operation performed depends mainly on where in the rectum the tumour is located, which determines whether the bowel can be reconnected or not.

Low anterior resection (LAR) vs abdominoperineal resection (APR)

Low anterior resection is used for cancers in the upper or middle rectum. The cancerous section is removed and the remaining rectum is reconnected to the colon, preserving normal bowel function in most cases, sometimes with a temporary colostomy while the new connection heals. Abdominoperineal resection is needed for cancers in the lower rectum, close to the anus, where there is not enough healthy rectum left to reconnect. This removes the rectum and anus entirely and requires a permanent colostomy, an opening in the abdomen through which waste is passed into an external bag.

Pelvic exenteration for advanced cases

For more advanced rectal cancers that have grown into nearby structures, a more extensive surgery called pelvic exenteration may be needed, removing the rectum along with other pelvic organs such as the bladder, prostate, or parts of the reproductive organs, depending on what the cancer has invaded. This is reserved for specific advanced cases and is a considerably larger operation than standard LAR or APR.

Neoadjuvant treatment before surgery

Many rectal cancer patients, particularly those with locally advanced tumours, receive chemotherapy and radiation before surgery, called neoadjuvant treatment, to shrink the tumour and improve the chances of a complete surgical removal. Whether this applies to you depends on your specific stage and tumour characteristics, confirmed through imaging and biopsy before a treatment plan is finalised.

Open, laparoscopic, or robotic surgery

Rectal cancer surgery can be performed as open surgery through a larger abdominal incision, or through minimally invasive laparoscopic or robotic technique using small incisions and a camera. Where suitable, minimally invasive approaches generally mean less pain, a shorter hospital stay and faster recovery, though the choice depends on tumour location, size and the complexity of your specific case.