When is a colostomy required for colon cancer surgery?

Doctor's Answers 1

Photo of Dr Nan Yaw Wong
Dr Nan Yaw Wong

Colorectal Surgeon

There are 2 types of colostomy : temporary and permanent.

During colorectal cancer surgery, the segment of bowel containing the cancer is removed and healthy bowels are joined back together to form a joint, or what surgeons call an anastomosis. For cancers that are near the anus muscles (so called low tumours), the chance of leakage after the anastomosis is formed is higher than cancers that are further away from the anus (high tumours).

Therefore, temporary colostomies are created after operation for low tumours to divert the fecal stream away from a fragile anastomosis to give it a better chance to heal. Colostomies are frequently not necessary after operation for a high tumour.

Temporary colostomies are closed at a later date once the anastomosis is deemed to have healed using special X rays. This varies from 1-3 months after the operation.

Permanent colostomies are created when the tumour is so low it involves the anal muscles. The anus is therefore sacrificed during the operation and the remaining colon is brought out on the abdomen as a "new anus". The bottom end is then closed permanently. The patient then lives with the stoma for the rest of his/her life.

A colostomy, whether temporary or permanent, is easy to manage, odourless, hides easily under clothings, and has negligible impact on quality of life. The patient is able to continue his or her way of life with no fuss. There are quite many prominent public figures with a permanent colostomy and they carry on their public functions without anyone knowing. I have many patients with permanent colostomies and no one has ever come back and say they regretted their operation.

You should contact the Ostomy Association of Singapore. They will send someone who lives with a colostomy to visit and show it isn't something to be afraid of.

Similar Questions

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If you truly have reasons to worry about having colon cancer, please do not delay any longer. It is a well-known fact that survival is best when colon cancers are detected early. If you are 50yr and above or having a significant family history of colon cancer or you have a past history of colon polyps, you automatically fall into a higher risk group for having colon cancer. So many have made the mistake of assuming a benign cause of bleeding just because one has a past history of haemorrhoids. Such assumptions may result in unnecessary delay in making the right diagnosis.

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Answered By

Dr Wai Leong Quan

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How much does colon cancer surgery cost in Singapore, and is it Medisave claimable in private?

Colon cancer surgery is complex and requires a team of specialists, nurses and specialised equipment. The average number of days in hospital is 7-10 days after the operation. As the cost depends on the complexity of the case and the technique used, it is difficult to quote a number but it would roughly range from $40,000 to $70,000 all inclusive. Colorectal cancer surgery is Medisave and insurance claimable. It would be best to contact your insurance provider as they are the best persons to answer your policy questions.

Photo of Dr Nan Yaw Wong

Answered By

Dr Nan Yaw Wong

Colorectal Surgeon

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