What kind of surgery do I need for my colorectal cancer? The type of surgery to be performed should depend on the site, size, and the grading and staging of the tumor. However, the surgical approach may vary depending on the surgeon’s opinion, training, skill and experience. It is important to discuss directly with the surgeon the full range of surgical options available and the surgical approach that will be chosen for the current colorectal cancer. There are two main types of surgery, the first is called palliative surgery; the second is called radical surgery. Palliative surgery is for patients with advanced incurable disease, and the purpose of this surgery is to relieve symptoms so that the patient lives longer and has a better quality of life. Radical resection is the removal of arteries, veins and lymph including those around the tumor, i.e. the whole area of tissue where cancer cells may remain. What are the possible complications after colorectal cancer surgery? The mortality rate for major surgery is less than 3%, a figure that increases exponentially with emergency or palliative surgery. One third of postoperative deaths are due to infection caused by anastomotic leakage. Other causes of death are mainly cardiac, respiratory and venous thromboembolic problems, such as pulmonary embolism. These complications are most often seen in older patients and in those with comorbidities. Infectious complications can manifest as anastomotic leaks, wound infections or intra-abdominal infections. Other infections include peripheral and central venous infections and respiratory tract infections. Infections are more likely to occur in diabetic patients and in patients with immune decline. Pulmonary infections are more common in patients with limited activity and prior pulmonary disease such as bronchiectasis, bronchiectasis, and asthma. The incidence of anastomotic leaks can be reduced, but they cannot be completely prevented no matter how much care the surgeon takes. With ultra-low anastomoses, the incidence of leak can still reach 5-10% even with the most experienced surgeons. For such a high risk, a temporary diversion stoma is usually used, which can be closed in about one to three months. When does the anus need to be removed and will the patient need to use a stoma bag for the rest of his or her life? The most important factor in determining whether the anus needs to be removed is the distance between the lower edge of the tumor and the upper edge of the anal sphincter. If the distance is too small to ensure sufficient border to achieve complete removal of the tumor and to ensure the lowest possibility of recurrence, the anus must be sacrificed. Specialists may seek to preserve the tumor 3-5 cm from the anal verge depending on the length of the anal canal. However, this decision should also be made with reference to the degree of local invasion, the grading of the cancer, the anatomical type of the pelvis and the size of the tumor. What is adjuvant therapy? Adjuvant therapy is an additional treatment given before or after surgery for colorectal cancer to increase the patient’s chances of cure. Usually this means chemotherapy and/or radiation therapy.