Dear OncoLink "Ask The Experts,"
My father (65 years old) underwent a colon cancer surgery in December 2005. The proximal one-third of the colon (the cecum, ascending colon, and half of the transverse colon) was removed, and it was anatomized with the distal part of the small intestine. Although there was no lymph node involvement, he is currently finishing up recommended chemotherapy. All of the tumor markers to date have come back negative. The only complaint he has is the feeling of pulling, discomfort, and gas, around the presumptive area of the anastomosis. His surgeon consulted with him and the possible explanation is "impaired passage and disrupted peristalsis."
What can alleviate this condition? Is this complaining pretty common, or should it be of concern? Is it possible that these symptoms are going to lessen or disappear in time?
Najjia N. Mahmoud, MD, Assistant Professor of Surgery at the Hospital of the University of Pennsylvania in the Division of Colon and Rectal Surgery, responds:
Post-surgical pain is fairly common, but usually goes away after several months. If the patient continues to have pain or symptoms of obstruction, a follow-up imaging study like a CT scan of the area is usually in order. Blood work (WBC, hemoglobin, and electrolytes) are also typically ordered. If the ordering physician believes that the problem may lie with the size or configuration of the connection (anastomosis) itself, either a barium enema or colonoscopy may be required. Anastomotic strictures occur when scar tissue builds up around the anastomosis and causes obstruction. Obstruction can cause pain and pressure. It is easily investigated by the methods listed above, and if discovered, corrective action can be taken.
Apr 16, 2014 - In patients with synchronous stage IV colorectal cancer who receive up-front modern combination chemotherapy, immediate colon surgery to remove the primary tumor is seldom necessary, according to research presented at the annual meeting of the American Society of Clinical Oncology, held from May 29 to June 2 in Orlando, Fla. These findings accompanied several other studies presented at the conference focusing on treatment of gastrointestinal cancers.
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