45172 Excision of rectal tumor, transanal approach; including muscularis propria (ie, full thickness)

Name of the Procedure:

Excision of Rectal Tumor, Transanal Approach; Including Muscularis Propria (Full Thickness)

Summary

The excision of a rectal tumor using a transanal approach involves the surgical removal of the tumor through the anus. This procedure typically includes the full thickness of the tumor, extending into the muscular wall of the rectum.

Purpose

This procedure is primarily used to treat rectal tumors that need to be removed due to cancer or other serious conditions. The goal is to eliminate the tumor while preserving as much of the normal rectal tissue as possible.

Indications

• Presence of a rectal tumor, particularly if it is malignant or precancerous
• Symptoms such as rectal bleeding, pain, or bowel obstruction
• Tumors that have not responded to other treatments like chemotherapy or radiation

Preparation

• Fasting for 8-12 hours before the procedure
• Bowel preparation with laxatives or enemas as prescribed
• Preoperative blood tests and imaging studies such as MRI or CT scans
• Review of current medications; some may need to be paused before surgery

Procedure Description

1. The patient is administered either general or regional anesthesia.
2. A specialized instrument called a retractor is used to widen the anus.
3. The surgeon uses surgical tools to carefully excise the tumor, including the full thickness of the rectal wall if necessary.
4. The excised tissue is sent for pathological examination.
5. The surgical site is checked for bleeding and is closed with sutures or staples.

Duration

The procedure typically takes about 1-2 hours.

Setting

This surgery is usually performed in a hospital operating room.

Personnel

• Colorectal surgeons
• Surgical nurses
• Anesthesiologist
• Pathologist (for examining excised tissue)

Risks and Complications

• Bleeding
• Infection
• Injury to surrounding tissues
• Rectal stricture or narrowing
• Anesthesia-related risks
• Potential need for further surgery

Benefits

• Removal of the tumor can alleviate symptoms and prevent further health complications
• Potential cure for early-stage rectal cancer
• Minimal invasive approach compared to open surgery

Recovery

• Hospital stay of 1-2 days post-procedure
• Pain management with prescribed medications
• Limited physical activity for 2-4 weeks
• Follow-up appointments for wound care and to monitor healing
• Possible dietary adjustments

Alternatives

• Chemotherapy and radiation therapy
• Endoscopic mucosal resection
• Open abdominal surgery Pros and cons of each alternative depend on the tumor's size, location, and whether it has spread to other tissues.

Patient Experience

• During the procedure, the patient will be under anesthesia and should not feel discomfort.
• Postoperative pain can usually be managed with medications.
• Patients might experience mild discomfort, rectal bleeding, or constipation during the initial recovery period.
• Full recovery typically occurs within a few weeks, though complete healing of the surgical site may take longer.