45190 Destruction of rectal tumor (eg, electrodesiccation, electrosurgery, laser ablation, laser resection, cryosurgery) transanal approach

Name of the Procedure:

Destruction of rectal tumor via transanal approach (e.g., electrodesiccation, electrosurgery, laser ablation, laser resection, cryosurgery)

Summary

This procedure involves the removal or destruction of a tumor located in the rectum using methods like electrodesiccation, electrosurgery, laser ablation, laser resection, or cryosurgery, accessed through the anus.

Purpose

This procedure is undertaken to remove cancerous or benign tumors in the rectal area.

Indications

• Presence of a rectal tumor identified through diagnostic imaging or colonoscopy.
• Symptoms like rectal bleeding, pain, or changes in bowel habits.
• Non-responsive tumors to medication or those deemed unsuitable for other treatments.

Preparation

• Patients might need to fast for a certain period before the procedure.
• Bowel preparation involving laxatives or enemas to clear the rectum.
• Pre-procedure diagnostic tests like imaging or blood tests.

Procedure Description

1. The patient is placed in a position suitable for transanal access.
2. Anesthesia or sedation is administered.
3. Specialized instruments are inserted through the anus to reach the rectum.
4. The tumor is targeted and destroyed using one of the following methods:
   • Electrodesiccation: uses electric current to dry out and destroy the tumor.
   • Electrosurgery: uses electric currents to cut and coagulate the tumor tissue.
   • Laser ablation: uses laser light to vaporize the tumor cells.
   • Laser resection: uses laser to cut and remove the tumor.
   • Cryosurgery: uses extreme cold to freeze and destroy the tumor cells.
5. The site is then inspected for completeness, and instruments are removed.

Duration

The procedure typically takes between 30 minutes to 2 hours, depending on the tumor size and method used.

Setting

The procedure is usually performed in a hospital, outpatient clinic, or a specialized surgical center.

Personnel

The procedure involves a colorectal surgeon, an anesthesiologist, and nursing staff.

Risks and Complications

• Bleeding
• Infection
• Perforation of the rectum
• Pain
• Stricture formation or scarring

Benefits

• Removal of the tumor, potentially reducing symptoms and risks of complications.
• Minimized recovery time compared to more invasive surgeries.

Recovery

• Post-procedure monitoring for a few hours.
• Instructions on diet, activity, and wound care.
• Pain management with prescribed medication.
• Follow-up appointments to monitor healing and further treatment needs.

Alternatives

• Watchful waiting in non-symptomatic cases.
• Other surgical options like transanal endoscopic microsurgery (TEM) or low anterior resection (LAR).
• Non-surgical treatments like radiotherapy or chemotherapy.

Patient Experience

• Mild to moderate discomfort during recovery.
• Pain management options are provided.
• Possible temporary changes in bowel habits.