What to expect - LAR

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Cocopuff
Posts: 2
Joined: Tue Feb 12, 2019 10:26 pm

What to expect - LAR

Postby Cocopuff » Tue Feb 19, 2019 1:10 pm

Hi all,

I am scheduled for a laparoscopic LAR next week. I've read many posts here, which have been such a wonderful help and valuable source of information.

My tumor is at the rectosigmoid junction, 15cm from the anal verge. My surgeon says its a judgment call as to whether to treat it as a rectal cancer or a colon cancer but he's going with colon and will proceed with LAR. He thinks the risks of LARS is low, especially because my resection will be "higher up." Does this make sense?

Pathology from the colonoscopy came back non-malignant (tubulovillous adenoma) but both the board-certified GI who did the colonoscopy and this board certified colorectal surgeon say that the top of the mass looks malignant. LAR would occur regardless because of the size and shape of the mass (sessile). Two other tubular adenomas were removed during the colonoscopy.

I would appreciate any guidance or tips on what to expect for the LAR and recovery time period. I am told that there is a strong likelihood that I will need chemo after surgery, but they won't know for certain until after surgery. It's been an overwhelming two weeks of doctors and second opinions. I feel very encouraged with the team at the University of Pennsylvania but still quite anxious about everything and all the unknowns.

Thank you!
39F, mother to 3 and 5 year old daughters
2/7/19 - colonoscopy; 5cm tumor 15cm from anal verge
tubulovillous adenoma, malignancy cannot be ruled out
2/19/19 - second opinion at HUP, sigmoidoscopy presumed colorectal cancer
2/27/19 - scheduled for laparoscopic LAR

NHMike
Posts: 2555
Joined: Fri Jul 21, 2017 3:43 am

Re: What to expect - LAR

Postby NHMike » Tue Feb 19, 2019 5:47 pm

I would assume that you'll have the LAR and a temp ileostomy put in that will allow your large intestine to heal and make things easier for adjuvant chemo. But you should check with your surgeon on this. I had surgery on Monday and left the hospital on Friday so four nights. I've heard of people going home after two nights and some that take much longer due to complications. You're young, though, and that counts for a lot.

If you have an ileostomy, they will need to train you on how to take care of it. It might be helpful to have a spouse or other helper to observe as I almost always had help at home when changing the bag. You''ll need to know how to order supplies and you might want to experiment with types and brands to see what works for you. There's quite a bit to learn about living ileostomy bags.
6/17: ER rectal bleeding; Colonoscopy
7/17: 3B rectal. T3N1bM0. 5.2 4.5 4.3 cm. Lymphs: 6 x 4 mm, 8 x 6, 5 x 5
7/17-9/17: Xeloda radiation
7/5: CEA 2.7; 8/16: 1.9; 11/30: 0.6; 12/20 1.4; 1/10 1.8; 1/31 2.2; 2/28 2.6; 4/10 2.8; 5/1 2.8; 5/29 3.2; 7/13 4.5; 8/9 2.8, 2/12 1.2
MSS, KRAS G12D
10/17: 2.7 2.2 1.6 cm (-90%). Lymphs: 3 x 3 mm (-62.5%), 4 x 3 (-75%), 5 x 3 (-40%). 5.1 CM from AV
10/17: LAR, Temp Ileostomy, Path Complete Response
CapeOx (8) 12/17-6/18
7/18: Reversal, Port Removal
2/19: Clean CT

CF_69
Posts: 109
Joined: Sat Dec 22, 2018 9:44 pm

Re: What to expect - LAR

Postby CF_69 » Sun Feb 24, 2019 10:18 am

My tumor is pretty much in the exact same place.

I’ve been treated as rectal, and had my last radiation treatment a little over a month ago.

My surgeon said that I will lose 1/3 to 1/2 of my rectum. He also said that it’s most likely I will have a temporary stoma.

My surgery is 2-4 weeks away. Had a CT scan last week and an MRI in a couple of days.

Good luck.
47 at diagnosis
Rectosigmoid junction
Adenocarcinoma
2.8 x 1.8 x 3.5 cm
G2
T3N0M0
CEA:
December 2018 - 1.9
September 2019 - 2.5
March 2020 - 2.3
September 2020 - 2.5
Xeloda / radiation x 25
Laparoscopic LAR April 2019
0 of 12 nodes
Stage 2A
4 cycles of adjuvant Xeloda
MRI on liver for 2mm hypodensity not suspicious.
Clear CT - September 2019
Clear CT - October 2020


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