Anterior Resection in Rectosigmoid Tumors
Anterior resection is a type of surgery widely used to remove rectosigmoid tumors that arise at the sigmoid colon-rectum junction. The tumors may be benign or malignant, with colorectal cancer being a major concern. The procedure involves removing the tumor while maintaining bowel function; hence, it is a treatment of choice for localized cancers. This article discusses the procedure, efficacy, complications, recovery, and expenses in various countries such as India and China.
What is anterior resection?
Anterior resection is a kind of surgery for the colon where the damaged part of the rectosigmoid colon is taken out, and the healthy ends are joined back together (anastomosis). The procedure can be performed via open surgery or minimally invasive techniques like laparoscopy or robotic-assisted surgery. The goal is to eliminate the tumor while maintaining continence and normal bowel movements.
Indications
The following conditions call for anterior resection:
- Rectosigmoid cancer (primary treatment for localized tumors)
- Large benign polyps that cannot be removed via colonoscopy
- Diverticular disease with complications like strictures or fistulas
- Inflammatory bowel disease (rarely, if medical therapy fails)
Procedure Details
- Preoperative Preparation – Includes bowel preparation, antibiotics, and imaging (CT/MRI).
- Anesthesia – General anesthesia is administered.
- Surgical Approach –
- Open surgery: A single large abdominal incision.
- Laparoscopic/Robotic: Small incisions with camera-guided instruments.
- Tumor Removal – The affected colon segment and nearby lymph nodes are excised.
- Anastomosis – The remaining colon is reattached to the rectum.
- Temporary Stoma (if needed) – In some cases, a colostomy may be created to allow healing.
Effectiveness
Anterior resection has high success rates when performed for early-stage cancers, with 5-year survival rates exceeding 80% for Stage I and II tumors. Laparoscopic methods reduce recovery time and complications compared to open surgery.
Risks and Side Effects
- Short-term risks: Infection, bleeding, anastomotic leakage, bowel obstruction.
- Long-term risks: Altered bowel habits (LARS – Low Anterior Resection Syndrome), sexual dysfunction, stoma-related issues.
Recovery and Aftercare
- Hospital Stay: 5–7 days (laparoscopic) or 7–10 days (open surgery).
- Diet: Gradual reintroduction of solid foods; high-fiber diet later.
- Activity: Light walking encouraged; heavy lifting avoided for 6–8 weeks.
- Follow-up: Regular scans and colonoscopies to monitor recurrence.
Cost and Availability
Anterior resection is widely available in specialized hospitals. Costs vary based on surgical approach and healthcare systems.
Patient Experiences
Many patients report significant improvement post-surgery, though some face challenges like temporary incontinence or dietary adjustments. Emotional support and rehabilitation play a crucial role in recovery.
Cost Comparison in Different Countries
| Country | Open Surgery Cost (USD) | Laparoscopic Cost (USD) | Robotic Surgery Cost (USD) |
|---|---|---|---|
| USA | 25,000–50,000 | 30,000–60,000 | 40,000–80,000 |
| India | 4,000–8,000 | 6,000–12,000 | 10,000–18,000 |
| China | 5,000–10,000 | 7,000–14,000 | 12,000–20,000 |
| Israel | 15,000–30,000 | 20,000–35,000 | 25,000–45,000 |
| Malaysia | 7,000–14,000 | 9,000–16,000 | 15,000–25,000 |
| Korea | 10,000–20,000 | 12,000–25,000 | 18,000–30,000 |
| Thailand | 6,000–12,000 | 8,000–15,000 | 14,000–22,000 |
| Turkey | 5,000–12,000 | 7,000–15,000 | 12,000–20,000 |
Treatment Options in India and China
- India: Top hospitals like AIIMS, Apollo, and Fortis offer laparoscopic and robotic anterior resection at affordable costs.
- China: Leading centers in Beijing and Shanghai provide advanced robotic-assisted surgeries with high success rates.
FAQ
1. Is anterior resection a major surgery?
Yes, but minimally invasive techniques reduce risks.
2. Will I need a colostomy after surgery?
Only if complications arise; most cases avoid permanent stomas.
3. How long does recovery take?
Full recovery may take 6–12 weeks.
4. Can the cancer return after surgery?
Recurrence is possible, necessitating regular follow-ups.
Anterior resection is a highly effective treatment for rectosigmoid tumors, with advancements in minimally invasive techniques improving outcomes. Costs vary globally, with India and China offering affordable, high-quality care. Early diagnosis and expert surgical intervention are key to successful recovery.