Surgery is not the main treatment for anal cancer. Often the first step is radiation therapy combined with chemotherapy. Depending on the tumor’s size and location, your surgeon may recommend surgery.
Two Main Types of Surgery
A local excision is for small tumors in the anal margin (outer layer of the anus) that have not spread. Your surgeon removes the tumor and a little tissue around it to get all the cancer cells. Most people have normal bowel action after a local excision. In rare cases, it can cause problems with how well you can control your bowel. Your colorectal care team can offer special tools or treatments to get you back to normal as soon as possible.
Abdominoperineal resection (APR) is used for anal cancer that didn’t fully respond to radiation and chemotherapy or that came back after treatment. During an APR, your surgeon removes the anus, rectum and lower part of the colon. Your surgeon makes an opening called an ostomy. They bring a piece of your intestine to the outside of your abdomen (belly). This is where stool and gas will leave your body. When a piece of the colon is used to create an ostomy, it’s called a colostomy. Some ostomies are permanent.
Additional types of surgery may be recommended, such as:
Traditional or “Open” Surgery
Traditional surgery is often called open surgery. It usually involves
a single incision (cut) that is large enough so that a surgeon can
operate using their hands.
Why your surgeon would recommend open surgery:
- The tissue that needs to be removed will not come out without a larger incision.
- If you have had many other abdominal surgeries and scar tissue is expected.
- If the cancer has spread (metastasized) beyond the anus to other organs,
open surgery may be the most efficient way to remove tumors from the anus and other organs at the same time.
Minimally Invasive Surgery
Laparoscopy
During a laparoscopy, your surgeon uses a thin, lighted tube with a video camera at its tip. This tool is called a laparoscope. Multiple small holes are made in the abdominal wall to insert camera and instruments into the abdomen. Once the goals of the operation are accomplished, a small incision is made to remove the tissue of concern.Robotic-assisted surgery
In robotic-assisted surgery, a camera and instruments are inserted through keyhole-size cuts in the abdominal wall, just like laparoscopy. Then robotic arms are attached to the instruments and your surgeon sits at a computer and uses controls to move the robotic arms. A high-definition visual system helps your surgeon see more clearly by magnifying the operation.
Why your surgeon would recommend one of these minimally invasive procedures:
- Surgeons can use smaller incisions than in open surgery.
- These techniques can help minimize damage to nearby organs and tissues.
- A lower risk of infection and less blood loss.
- Patients often recover faster.
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