Transanal excision is a procedure used to treat patients with early colorectal cancer. This procedure was designed to preserve the function of the sphincter in colorectal cancer patients and eliminate any fecal incontinence. The transanal excision works well on a stage 1 rectal cancer that’s located near the anal opening, but hasn’t spread to the anus or sphincter.
This procedure is performed in order to remove rectal tumors and small amounts of surrounding tissue while leaving the anus and sphincter intact. Following the surgery, most patients will receive radiation and/or chemotherapy.
-Effective in preventing the spread of rectal cancer to other local and distal parts of the body
-Pain and discomfort after surgery.
-Follow up treatment usually involves chemotherapy and radio therapy
A transanal excision may be performed with local or general anesthesia, depending on your doctor’s recommendation and your preference. The surgery may be done with or without an endoscope. (When performed with an endoscope, this procedure is called transanal endoscopic microsurgery.) Polyps, if present, will be removed with a wire snare then loops around the polyp. Electricity is then used to burn or destroy the tissue. Other growths will be removed with appropriate tools. A minimal amount of normal tissue (margin) is also usually removed. No incision will be made on the skin and no stitches are necessary.
You will undergo a physical examination as well as blood tests, a chest x-ray, and an electrocardiogram (EKG). A few days before the procedure, your intestines will need to be cleaned out. This may mean that you will have to be on a clear liquid diet for one to three days before the procedure, followed with laxatives on the day of the procedure. Please let your doctor know about all medication that you are taking as some will need to be stopped before the procedure. You will probably need to stop your liquid diet six to eight hours before the procedure, or as recommended by the doctor.
Some pain is normal after the procedure and can be managed with medication. You will probably be able to go home the next day if there are no complications. You can return to normal activities as you are comfortable doing so, but will likely need to take it easy for a few days. The doctor will discuss further treatment with you as it is common for patients to follow up the surgery with radiation and/or chemotherapy for the most effective results.
Complications are uncommon with this procedure, but may include bleeding from the surgical site and perforation of the colon or rectum. There is also the risk of infection and reaction to anesthesia, usually if general anesthesia is used.
How will transanal excision affect my sex life?
Rectal surgery has been linked to sexual problems and quality of life issues in both men and women. The surgery may affect males and females in different ways. Different sexes may experience the following effects: Men - You may experience a decrease in erections or your ability to reach an orgasm. In other cases, your pleasure at orgasm may become less intense. Normal aging may cause some of these changes, but they may be made worse by the surgery. Women - Rectal surgery (except pelvic exenteration) usually doesn't cause any loss of sexual function. Abdominal adhesions (scar tissue) may sometimes cause pain or discomfort during sex. If your uterus is removed, you won't be able to get pregnant.
Is surgery a definitive cure for rectal cancer?
Your surgeon will resect the portion that they deem to be cancerous. In addition, they will also remove surrounding normal tissue as standard procedure to ensure that all the cancerous tissue is removed. The Lymph nodes are not removed during this surgery, so adjuvant therapy involving radiation with or without chemotherapy might be recommended after surgery if the cancer has grown deep into the rectum, was not removed completely, or has signs of spread into the lymph system or blood vessels.