Sep 29, 2015


Dr. Miller: You've been diagnosed with colon cancer and now you have a lot of questions before surgery. We're going to talk about that next on Scope Radio.

Announcer: Access to our experts with in-depth information about the biggest health issues facing you today. The Specialists, with Dr. Tom Miller, is on The Scope.

Dr. Miller: I'm here today with Dr. Bartley Pickron. He is a surgeon here at the University of Utah and also a specialist in colorectal surgery. Hi, Bartley, how are you today?

Dr. Pickron: Doing great, thanks.

Dr. Miller: I think our audience would like to know a little bit about the surgery involved with colon cancer. Is it any easier than it used to be? Is there a big incision? And I think one of the questions that patients will probably almost always ask is if they're going to need a pouch after the surgery to collect stool.

Dr. Pickron: The last point you made is probably the most accurate. Yeah, the biggest question I get asked is, "Do I need a bag after surgery?" And for the vast majority of patients, that answer is no.

Dr. Miller: That's a big relief to a lot of people.

Dr. Pickron: It is, yeah and so, the majority of the people their tumor is located in such an area that the portion of the colon containing the tumor can be resected. The other two ends are put back together and there are some adjustments with that kind of function, but, at the end of the day, there is no bag.

Dr. Miller: Now the surgery is also a little less dramatic now. There's not a big incision. Can you talk a little about the tools you use to perform the surgery?

Dr. Pickron: No, absolutely. It used to be that when doing cancer surgery, if you didn't have a big enough incision, you weren't doing the right job. And now we've found that's not really true. We usually use incisions that are maybe half an inch in size to do all the internal dissection and then we have to make an incision maybe two inches in size to remove the colon once all the work inside is done.

Dr. Miller: So less tissue disruption, less trauma to the body so I would guess most patients are out of the hospital sooner than they used to.

Dr. Pickron: Oh, absolutely. Average stay is usually two to three days and overall recovery is a lot faster than it used to be in just a matter of weeks as opposed to months.

Dr. Miller: Wow, that's great. If they do need a pouch, I understand that sometimes that's for a certain period of time and then you can hook the ends of the bowel together again at some point. Is that true, or not true?

Dr. Pickron: No, it's absolutely true. For most patients who do have a bag put on at surgery, it's a temporary situation to allow the area where we hook the other pieces of colon to heal. And then, once that's healed after a period of maybe three months or so, then we would go back and reconnect it.

Dr. Miller: So even if you do end up having a pouch, chances are that it could be changed out and your colon reconnected again.

Dr. Pickron: For most of the time. There is the kind of the subset of patients who end up with a permanent colostomy or a permanent bag are the ones with tumors right on, right at, or very close to the anal opening.

Dr. Miller: Have there been advances in the way that these pouches are put on so that it's a little easier for people to use and a little more convenient, if that's possible?

Dr. Pickron: Well, not only that but also the support system that a lot of people have is phenomenal. I mean there's our ostomy nurses who can help them learn how to use them. There are support groups in the community where they can meet with people who function with these bags on a day-to-day basis. And for the vast majority of time, if you saw a guy walking down the street you'd never know he had a bag on.

Dr. Miller: So things have changed a lot in the last 25 years related to this type of treatment.

Dr. Pickron: Much for the better.

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