Bowel cancer surgery

Information about surgery for bowel (colorectal) cancer.

About bowel cancer surgery

  • Surgery to remove the affected part of the bowel is the main treatment for bowel (colorectal) cancer. 
  • If the cancer is found early, surgery can often cure it.
  • If the cancer is very small you may only need a small surgical procedure to remove it (local resection).
  • You may have a stoma after surgery − an opening on your tummy that lets poo leave your bowel into a bag.

Types of surgery for bowel cancer

Which part of your bowel will be removed depends on where the cancer is. 

  • Sigmoid colectomy: removes the sigmoid part of the colon 
  • Total colectomy: removes all of the colon
  • Panproctocolectomy: removes all of the colon and rectum

Sigmoid colectomy

2 diagrams, one showing the part of a colon with a tumour in it and the other showing the tumour removed and the bowel rejoined.

Transverse colectomy

2 diagrams, one showing the part of a colon with a tumour in it and the other showing the tumour removed and the bowel rejoined.

Hemicolectomy

2 diagrams, one showing the part of a colon with a tumour in it and the other showing the tumour removed and the bowel rejoined.
Images courtesy of Cancer Research UK / Wikimedia Commons

Ways of doing bowel surgery

A small cut is made in your abdomen (tummy area). 

Your surgeon will put a tube with a tiny telescope and light inside your body through the cut. Special instruments can then be used to remove the tumour. 

There is usually a quicker recovery with keyhole surgery than with open surgery and you may spend less time in hospital . Although the scar on your tummy will be smaller, your bowel will still need the same amount of healing – it’s important you give yourself time to recover. 

Your surgeon will discuss if keyhole surgery is suitable for your type of bowel cancer and if this type of surgery is available in your hospital.   

This is a type of keyhole surgery that uses a computer and robotic arms to help to remove the tumour. Your surgeon will discuss if robot-assisted surgery is suitable for your type of bowel cancer and if this type of surgery is available in your hospital.

A long cut is made in your abdomen. This means your wound will go from below your breastbone down towards your pelvis in a straight line. The length will depend on where the cancer is.

Stomas / colostomy

Sometimes part of your bowel is brought out onto the surface of your tummy. This is called as stoma. You may have a temporary stoma to allow the join in your bowel to heal. Or some people may have a permanent stoma because it’s not possible to join up the ends of your bowel again. Read more about how to care for your stoma and stoma reversal.

Colostomy diagram

Possible side-effects from bowel surgery

General side-effects

With all surgeries there is a small risk of bleeding and infection. Read more about general side-effects of surgery.

Caring for your stoma

Keep the stoma clean and free from tissue or crusts. This is to prevent it getting blocked, which could interfere with your breathing. It will also stop the skin around the stoma getting sore and help to prevent infection.

You may have a lot of secretions or phlegm initially after the surgery but this will reduce by the time you go home.

Using a small freestanding, table-top mirror can make it easier to see what you are doing. It might be helpful to have a relative or close friend with you when learning to look after the stoma.

Depending on your surgery, you may have diarrhoea for a short while. Drink plenty of clear fluids and let your doctor and nurse know. They can give you medication to control it. If you have an ileostomy, contact your stoma nurse for advice on treating diarrhoea and drinking fluids.

Some people find their bowels are more active after surgery. As a result, you may have to control what you eat for a while. If you have a stoma, your bowels may move at certain times of the day. You may notice that your stoma is more active after a meal or that it works a little bit all day.

Sometimes wind can be a problem. It can build up and give you pain and discomfort. Talk to your nurse about taking peppermint water. Your doctor can prescribe medication to relieve it as well.

Sexual side-effects of bowel surgery

Most people have no problem resuming their sex life after bowel surgery. It may be a few weeks before you feel ready.

Others may find it harder, especially if their rectum has been removed (proctectomy). For example, surgery to the rectum can affect the nerves and blood supply to the sexual organs. This may result in problems such as:

  • Erection and ejaculation problems. This usually clears up over time.
  • Narrowing and shortening of the vagina. This can make sex painful. For some, it can also lead to a loss of sensation or less vaginal secretions. Usually simple solutions, such as lubricants, can help these problems. 

Getting support

If you have any sexual problems after your treatment, talk to your doctor and specialist nurse. They are used to dealing with these type of problems, so there’s no need to feel embarrassed. They can advise you on treatments, give you tips and also refer you for counselling – for you or for you and your partner – if you feel it would help. 

Stomas and sex

  • Body image: If you have a stoma it may change the way you feel about your body. You may also have concerns about how your partner will react. Try to talk to your partner about the way you are feeling. Talking can help to ease your anxiety. If you need more advice, talk to your doctor. He or she can refer you for special counselling if you feel it would help.
  • Food and drink: Try not to eat too much before sex. You could plan times for sex when a bowel movement is less likely. 
  • Managing the pouch: Empty the pouch before sexual intimacy. An empty and flat bag will not become loose from the stoma. It can be rolled up or taped down so it will not get in the way. It is possible to wear decorative covers as well. Smells can also be controlled. .
  • Intimacy: You may be afraid that the bag will interfere with sex, become dislodged or cause damage to the stoma. These are all normal fears. But an empty and flat bag will not become loose from the stoma. It can be rolled up or taped down so it will not get in the way.
  • Decorative covers: It is possible to wear decorative covers as well. There are also a variety of pouches to suit your needs. There are bands you can wear on your tummy for support and discretion. Your stoma care nurse can give you advice about this.
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