Colorectal Cancer Surgery

If you have received a colon or rectal cancer diagnosis, you will likely need colorectal cancer surgery. Your surgical options and the timing of when your surgery will take place depends on your stage and type of cancer.

hero symbol

If you have received a colon or rectal cancer diagnosis, you will likely need colorectal cancer surgery. Your surgical options and the timing of when your surgery will take place depends on your stage and type of cancer. There are different approaches to colorectal cancer surgery depending on if you have colon cancer or rectal cancer. 

To learn more about the colorectal cancer surgery process, watch our three-part video series and patient questions video with patient advocate, Danielle Ripley-Burgess, and colorectal surgeon, Dr. Lina O’Brien, for their conversation on surgical procedures and discussion of how colorectal cancer surgery has changed over the years as technology has advanced. 

Animated Video Series Sponsored by: Intuitive

Surgery Brochure
From side effects of surgery, types of colon and rectal cancer surgeries, questions to ask your medical team, to a packing list, the Fight CRC Colorectal Cancer Surgery brochure covers important information for you to consider – and things you may not have even thought about – before scheduling and heading to the hospital for your procedure. Make our medically reviewed Colorectal Cancer Surgery brochure your trusted resource.

Surgery for Colon Cancer

If you’ve been diagnosed with colon cancer, your first treatment step may be surgery to remove the primary tumor. A polypectomy or local excision, which removes a cancerous polyp from the body without an abdominal incision, may take place for the earliest-stage cancers (stages 0 and I). Later-stage cancers may require open or laparoscopic (minimally invasive) surgeries.

Surgery for Rectal Cancer

If you have been diagnosed with rectal cancer, you may be treated with radiation and chemotherapy prior to having surgery. It’s critical to discuss all of your surgical options and determine the goals of your treatment and surgery with your doctor.

Common Colorectal Surgery Techniques

Open Surgery

Open surgery is a type of surgery where a doctor makes a long cut (incision) to access the area where the surgery needs to be done. This type of surgery is usually done when the area being operated on is hard to reach, or when the surgery requires a larger opening to see and work in the area. After surgery, the cut will be closed up with stitches or staples. Open surgery usually requires a longer recovery time and can be more painful than minimally invasive surgery. However, sometimes open surgery is the best option for certain situations.

Minimally Invasive Surgery

Laparoscopic Surgery

Laparoscopic surgery uses multiple small incisions instead of one long cut. The doctor inserts a tiny camera and small tools into the cuts to remove the cancer. This can make recovery time shorter and less painful.

Robotic-Assisted Surgery

Robotic-assisted surgery is like laparoscopic surgery, but the doctor uses a console in the operating room to control tools held by a robotic machine. This method allows doctors to perform the surgery with more precision, flexibility, and control. Recovery time with this technique may also be shorter.

Types of Colorectal Cancer Surgery 


A polypectomy is most often performed during a colonoscopy and occurs when a doctor removes a polyp containing cancer from the colon. Although typically a minor and painless procedure, it’s considered a “surgery” and billed as such. This is usually the only surgery stage 0 or very early-stage I cancers need. You may not even be aware that you’ve had a polypectomy until your physician tells you!

Local Excision

Local excision is also considered a colorectal cancer surgery and billed as such. It does not require an abdominal incision and, like the polypectomy, is done by a colonoscope tool during a colonoscopy. During a local excision, a doctor removes the polyp containing cancer, as well as surrounding tissue, that will be sent to pathology for testing in order to determine the cancer’s stage.


A colectomy is a procedure, which removes a section of the colon that contains the cancer, as well as nearby lymph nodes. After the cancerous part of the colon is removed (resection), the two ends of the remaining colon are reattached (anastomosis) to eliminate waste through the rectum. This procedure is also referred to as:

  • Hemicolectomy
  • Partial Colectomy
  • Segmental Resection

A colectomy may be performed using traditional open techniques, laparoscopically, or robotically-assisted.

Colostomy (Ostomy)

A colostomy creates a way for stool to be removed from the body when the colon cannot function properly. In this procedure, a stoma (opening) is made to the outside of the body through the abdominal wall, and an ostomy pouch is placed around the stoma to collect and remove waste. A colostomy can be temporary and reversed, or it can be permanent.

  • Ostomy: the opening on the outside of the abdominal wall for waste
  • Stoma: the actual end of the intestine seen peeking through the abdominal wall
Temporary Ostomy and Reversal Surgery

A reversal surgery is possible if the colon heals after the initial resection surgery, which could take as long as several months. A reverse colostomy surgery (colostomy take-down) is performed since the stoma will no longer be necessary.

Low Anterior Resection (LAR)

LAR is a common surgery for treating rectal cancer. The tumor and part of the rectum are removed without affecting the anus. The colon is then attached to the remaining part of the rectum so that after the surgery, stool can exit through the anus like it did before the surgery. Sometimes a temporary ostomy is needed.

Abdominoperineal Resection (APR) with Ostomy

APR is another common surgery for rectal cancer patients. One incision is made in the abdomen and another in the perineal area to remove the anus and the tissues surrounding it, including the sphincter muscle. This is more extensive than a LAR surgery because the anus is removed. With an APR, patients receive a permanent colostomy.

What to Expect Before Surgery

  • Your blood counts will be measured
  • Your blood chemistry and CEA levels will be evaluated
  • You will have a CT scan of the chest, abdomen, and pelvis, or a PET scan, to determine exactly where the cancer is located
  • For rectal cancer, you may have an MRI and/or an endorectal ultrasound

These tests are often done after surgery to compare results.

Colorectal Cancer Surgery Side Effects

No medical procedure, drug, or surgery is 100% free from side effects. Your side effects will depend on your overall health and the type of surgery you undergo. Surgeries that don’t involve abdominal incisions may result in fewer disruptive side effects. The doctor who performs your surgery will explain what to expect and reasons to call the doctor following your procedure.

For surgeries that involve incisions, side effects, length of hospital stay, and recovery times will depend on the type of surgery you had and how your body reacts following the procedure. 

Gastric Feeding Tube (NG Tube)

Some patients who undergo abdominal surgeries receive an NG (nasogastric) tube for a portion of their hospital stay or possibly just during surgery. This tube is most often placed when you’re under anesthesia. It is inserted through a nostril and connects the stomach to an external pump so the stomach can empty while the colon “wakes up” following surgery. Not every patient will require an NG tube following surgery. Side effects of the NG tube can include:

  • Chaffing around the nose
  • Sore throat 
  • Irritation and aggravation (although temporary, many find this tube uncomfortable

A surgical incision will likely leave patients feeling sore and stiff, and most patients need pain medication following surgery for several weeks following the procedure. Pain may be managed with both narcotic and non-narcotic pain medications, depending on its severity. Narcotic pain medications especially may have undesirable side effects, such as constipation, so be sure to always follow dosing instructions carefully and discuss any worrisome side effects with your care team.


Many patients may experience nausea following colorectal cancer surgery. This can be a side effect from the surgery or anesthesia, but it can also come from the pain medication. Make sure to tell the nurse everything you’re experiencing following surgery, so they can identify the cause of nausea and make adjustments or run tests as needed.


Some surgeries may cause infection around the scar or result in other complications. If you experience anything abnormal, both when you’re admitted and discharged from the hospital, notify your doctor’s office immediately.


Following surgery, your diet will likely be restricted for a short period of time. Ask your doctor what to expect based on the type of surgery you undergo. Some patients are restricted to ice chips and liquid diets for a few days before resuming solid foods. For other patients who need extended periods of healing, TPN (total parenteral nutrition), which is administered via an IV, may be discussed and recommended.

More About Colorectal Cancer Surgery 

For more information, peruse the Fight CRC Resource Library for a number of additional resources, and the Fight CRC blog for stories from survivors who’ve undergone several of these colorectal cancer surgeries.