Bowel cancer surgery (Surgical resection for colorectal (bowel) cancer)

An operation to remove the part of the bowel containing a cancer, along with nearby lymph nodes, usually as part of a wider treatment plan agreed by a specialist team.

✓ Medically reviewed by a GMC-registered consultant · last reviewed September 2026 · next review September 2027 · how we review

In short

Surgery removes the part of the bowel with the cancer plus nearby lymph nodes, and offers the best chance of removing bowel cancer that has not spread widely.
It is one part of a plan agreed by a specialist team (MDT); some people also need chemotherapy or radiotherapy before or after the operation.
Surgery cannot guarantee the cancer will never come back — the pathology report on the removed tissue, follow-up scans and tests guide what happens next.
Some operations need a stoma (an opening on the tummy), which can be temporary or permanent; this should be discussed clearly beforehand, ideally with a stoma nurse.

A plain-English summary. The detail — including risks and recovery — is below.

At a glance

TypeMajor surgery to remove bowel cancer (open, keyhole or robotic)

AnaestheticGeneral anaesthetic, often with additional pain relief such as an epidural or spinal

How long it takesCommonly around 2–4 hours, depending on the operation

Hospital stayUsually several days in hospital; longer if there are complications

Time off workOften around 6–12 weeks before feeling recovered, sometimes longer

When you'll see resultsThe full result comes from the pathology report a couple of weeks after surgery

On the NHS?A core NHS cancer treatment; private care is also available, often alongside NHS care

A general guide. Your surgeon will give you advice for your situation.

Best fit

Offers the best chance of removing bowel cancer that has not spread widely

Pause if

People too unwell or frail to safely undergo major surgery and a general anaesthetic, for whom other treatments may be safer.

Main recovery point

You are monitored closely, with drips and pain relief. You will usually be encouraged to sit up, move and start drinking and eating early. Bowel function...

Good aftercare

Care within an enhanced recovery programme and a named contact (such as a colorectal nurse specialist) for problems.

First few days in hospital

You are monitored closely, with drips and pain relief. You will usually be encouraged to sit up, move and start...

Leaving hospital (often around 3–7 days)

Many people go home within a week of keyhole surgery, sometimes sooner; open surgery may mean a longer stay. You...

First few weeks at home

Gradually increase activity and walking. Avoid heavy lifting and strenuous activity. Bowel habit is often...

About 6–12 weeks

Many people feel much closer to normal, though full recovery and settling of bowel habit can take longer. Driving...

Medical line illustration of lower gi colonoscopy for Bowel cancer surgery. — Illustration only - not a diagnosis, medical advice or a promise of result. Your anatomy and treatment plan may differ. Vuemedics does not publish before-and-after photos.

What is bowel cancer surgery?

Bowel cancer surgery removes the section of bowel that contains the cancer, together with a margin of healthy bowel around it and the nearby lymph nodes (small glands that cancer can spread to). The two healthy ends are then usually joined back together (an anastomosis), or sometimes brought out onto the tummy as a stoma.

For most people with bowel cancer that has not spread widely, surgery offers the best chance of removing the cancer. It is usually part of a wider plan agreed by a multidisciplinary team (MDT) — a group of specialists including surgeons, cancer doctors, radiologists and specialist nurses — who use scans and tests to work out the type and stage of the cancer and the best order of treatment.

The exact operation depends on where the cancer is. Cancers in different parts of the colon or rectum need different operations, such as a right or left hemicolectomy, an anterior resection or, for some low rectal cancers, an operation that removes the back passage and needs a permanent stoma.

Some people also need chemotherapy or radiotherapy before or after surgery. Surgery aims to remove the cancer completely, but it cannot guarantee that the cancer will never return, which is why follow-up and sometimes further treatment are part of the plan.

Types & techniques

There isn't one single operation. The right approach depends on you — which is something to discuss with your surgeon.

Right or extended right hemicolectomy

Removes the right side of the colon (and sometimes part of the middle) for cancers in that area. The ends are usually joined together; a stoma is often not needed.

Left hemicolectomy / sigmoid colectomy

Removes the left side or the lower (sigmoid) part of the colon for cancers there. The ends are usually rejoined, sometimes with a temporary stoma to protect the join.

Anterior resection

Removes part or all of the rectum and the lower colon for many rectal cancers, then rejoins the bowel. A temporary stoma is often made to protect the new join while it heals.

Abdominoperineal resection (APR)

Removes the rectum and the anus for cancers very low in the rectum, leaving a permanent colostomy (stoma). Used when there is not enough healthy bowel below the cancer to rejoin.

Hartmann's procedure

Removes the affected bowel and brings the end out as a stoma without rejoining, often used in emergencies or when a join would not be safe. The stoma may sometimes be reversed later.

Total colectomy

Removes the whole colon, used in selected situations such as multiple cancers or certain inherited conditions; it may need a permanent or temporary stoma.

Keyhole vs open bowel cancer surgery

Point	Keyhole (laparoscopic)	Open
Cuts	Several small cuts	One larger cut
Recovery	Often quicker	Often slower
Hospital stay	Often shorter	Often longer
Cancer outcome	Similar in suitable cases	Similar
When used	Many planned operations	Large/complex tumours, emergencies

Keyhole (and robotic) surgery suits many but not all cases. Your surgeon chooses based on the tumour, your anatomy and safety; sometimes an operation that starts as keyhole is converted to open.

Preparing for your surgery

Make sure you understand the type and stage of your cancer, why surgery is recommended, and what the MDT has planned.
Ask which operation is proposed and whether a stoma is likely, temporary or permanent; ask to meet a stoma nurse beforehand if so.
Attend any pre-assessment, blood tests, scans and fitness checks, and follow advice on improving fitness before surgery (prehabilitation) if offered.
Tell the team about all medicines, especially blood thinners, diabetes medicines and steroids, and follow instructions on stopping or adjusting them.
Stop smoking and discuss alcohol, as this lowers the risk of complications.
Follow any bowel preparation, diet and fasting instructions for the day of surgery.
Arrange help at home for several weeks, including with lifting, shopping and childcare.
Ask about an enhanced recovery programme, which helps you eat, move and recover sooner after surgery.

What happens

Bowel cancer surgery is done under a general anaesthetic, often with an epidural or spinal injection to help with pain afterwards. Depending on the tumour and your situation, it may be done by keyhole (laparoscopic) surgery, robotic surgery or open surgery.

The surgeon removes the section of bowel containing the cancer, along with a margin of healthy bowel and the nearby lymph nodes and their blood supply. The healthy ends are then usually joined back together. Sometimes, to protect a join low down or because of an emergency or unhealthy bowel, the surgeon brings the bowel out onto the tummy as a stoma, which may be temporary or permanent.

The operation commonly takes a few hours. Afterwards you are cared for on a ward, or in a higher-dependency area if needed, with drips, pain relief and close monitoring. Many units use an enhanced recovery programme to help you start drinking, eating and moving early, which helps recovery.

Is this operation right for me?

A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.

May not be suitable if…

People too unwell or frail to safely undergo major surgery and a general anaesthetic, for whom other treatments may be safer.
Cancer that has spread so widely that surgery to remove it is not the right approach, where the focus may be chemotherapy or other treatment.
Very early cancers within a polyp that may be fully treated by local removal at colonoscopy instead.
Situations where the MDT judges that treatment before surgery (such as radiotherapy or chemotherapy for rectal cancer) should come first.

Delay surgery if…

There is an active, untreated infection or another acute medical problem that increases surgical risk.
Staging is incomplete and key scan or biopsy results are awaited.
Blood-thinning or other medicines need adjusting first.
The person is medically unstable and needs optimisation before surgery.
Pre-surgery treatment (radiotherapy or chemotherapy) is planned and not yet completed.

Alternatives to discuss

Treatment before surgery, such as radiotherapy or chemotherapy for some rectal cancers.
Local removal at colonoscopy for some very early cancers within a polyp.
Chemotherapy, radiotherapy or targeted treatment when surgery is not the right option.
A stent or stoma to relieve a blockage when major surgery is not immediately possible.
Best supportive (palliative) care focused on symptoms and quality of life when cure is not possible.

Before you decide

Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.

What matters most to me?

Think about symptoms, daily life, work, caring responsibilities, sport, fertility, travel, appearance and anxiety — the right choice depends on your priorities, not just the medical facts.

What are all my options?

Ask about waiting, monitoring, medicines, rehabilitation, a smaller or larger procedure, a different test, NHS referral, or a second opinion where that would help.

What would make me pause?

Active infection, pregnancy, unstable medical problems, smoking, medicines that increase bleeding, poor support at home, or feeling pressured are all reasons to slow down and get tailored advice.

What happens if I do nothing today?

For some problems, waiting is safe; for others, delay can make treatment harder. A good consultation should explain the trade-off in plain English.

Anaesthetic choices

The safest option depends on the operation, your health, the facility and your surgeon/anaesthetist. Ask what is planned and why.

General anaesthetic

You are fully asleep for the operation.

Epidural or spinal pain relief

A small tube or injection in the back can provide strong pain relief during and after surgery, helping recovery.

Nerve and local blocks

Local anaesthetic techniques may be added to reduce pain and the amount of other painkillers needed.

Benefits

Offers the best chance of removing bowel cancer that has not spread widely
Removes nearby lymph nodes so they can be examined to help stage the cancer
Can relieve or prevent a blockage or bleeding caused by the tumour
Provides the pathology information that guides whether further treatment is needed
Keyhole or robotic approaches can mean a quicker recovery for suitable people

Risks & complications

More common

Pain, tiredness and a reduced appetite for some weeks
Changes in bowel habit, such as looser or more frequent stools, especially early on
Temporary difficulty with the bowel waking up after surgery (ileus)
Wound discomfort and, if you have a stoma, time needed to learn to manage it

Less common

Wound or chest infection, or a urinary infection
Bleeding needing treatment or, rarely, a return to theatre
Blood clots in the legs or lungs (DVT or pulmonary embolism)
Leaking of the join in the bowel (anastomotic leak), which can need antibiotics, drainage or further surgery and a stoma

Rare but serious

Damage to nearby structures such as the ureter, bladder, bowel, spleen or nerves
A serious complication needing intensive care or further operations
Effects on bladder or sexual function, particularly after rectal surgery
Death — uncommon for planned surgery but higher in emergencies or in people who are frail or very unwell

The most serious specific risk is a leak from the join in the bowel (anastomotic leak), which can make you very unwell and sometimes needs further surgery and a stoma. Risks are higher in emergency operations, in rectal surgery, and in people who are older, frailer, or have other illnesses or are smokers. Surgery on the rectum can also affect bladder and sexual function. Ask your surgeon about your personal risk, the chance of needing a stoma, and what is done to reduce and detect complications.

Published figures to discuss

Risks and outcomes vary widely with the type of operation, whether it is planned or an emergency, the stage of the cancer, and the person's age and general health. Survival depends most on the stage at diagnosis. Figures below are broad indications from UK sources and large series, not a prediction for any individual; your team can give figures relevant to your situation.

Figure	Reported range	How to interpret it	Source / confidence
Anastomotic leak (leak from the bowel join)	Often around 2–5% for many colon joins, but published colorectal leak rates span about 2–19% and are higher for low rectal joins	A serious complication that can need antibiotics, drainage or further surgery and a stoma.	Risk factors for anastomotic leakage after colorectal surgery — review (PMC)pmc.ncbi.nlm.nih.govPublished figure
Overall 5-year survival for bowel cancer (all stages, UK)	Around 50–60% overall in UK population data, depending on definition and period	Strongly stage-dependent: much higher for early-stage disease and much lower for advanced disease.	Risk factors for anastomotic leakage after colorectal surgery — review (PMC)pmc.ncbi.nlm.nih.govPublished figure
Need for a stoma	Varies by operation: often none for right-sided cancers; common in rectal surgery and expected/permanent after APR	Some low rectal cancers (APR) need a permanent stoma.	Guide sourcesClinical context

These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.

Recovery — what to expect, and when

Recovery from bowel cancer surgery takes weeks, not days. Many people feel much better within about six weeks but take up to around three months to feel fully recovered, and longer if there are complications or further treatment. Enhanced recovery programmes help you move and eat sooner.

First few days in hospital

You are monitored closely, with drips and pain relief. You will usually be encouraged to sit up, move and start drinking and eating early. Bowel function may take a few days to return.

Leaving hospital (often around 3–7 days)

Many people go home within a week of keyhole surgery, sometimes sooner; open surgery may mean a longer stay. You may still feel sore and tired. If you have a stoma, you should be confident managing it before discharge.

First few weeks at home

Gradually increase activity and walking. Avoid heavy lifting and strenuous activity. Bowel habit is often unsettled. Eat regularly and stay hydrated.

About 6–12 weeks

Many people feel much closer to normal, though full recovery and settling of bowel habit can take longer. Driving, work and exercise restart gradually as advised.

Pathology results and ongoing care

The pathology report is usually discussed within a couple of weeks and the MDT advises on any further treatment such as chemotherapy, plus a follow-up plan.

What's normal — and not a worry

Tiredness and reduced appetite that improve over weeks
Looser, more frequent or urgent bowel movements, especially early on
Some wound soreness, and for a stoma, a learning period to manage it confidently
Emotional ups and downs while waiting for results and adjusting
Gradual return of energy and stamina over a couple of months

Aftercare

Take pain relief as prescribed and increase gentle activity such as walking day by day.
Eat regular, balanced meals and drink plenty of fluids; ask for dietitian advice if eating is difficult.
Avoid heavy lifting and strenuous activity for the time your surgeon advises, to reduce the risk of a hernia.
Look after your wounds and, if you have a stoma, follow your stoma nurse's advice on care and supplies.
Watch for and report signs of infection, a leak, or a blood clot promptly.
Take any prescribed blood-clot prevention (sometimes injections for a few weeks) as directed.
Attend follow-up appointments, scans and blood tests, and any further treatment that is planned.
Ask for support — specialist nurses, stoma nurses and cancer support services can help with practical and emotional needs.

Before-surgery checklist

Understood the planned operation and whether a stoma is likely
Met a stoma nurse if a stoma is possible
Pre-assessment, scans and fitness checks completed
Help at home arranged for several weeks
Medicines, including blood thinners, reviewed with the team
Stopped smoking and reduced alcohol where possible
Clear plan for follow-up, results and who to contact with problems

Scars and how they heal

Keyhole (laparoscopic) and robotic surgery leave several small scars on the tummy, sometimes with one slightly larger scar where the bowel is removed. Open surgery leaves a longer scar, usually down the middle of the tummy. If you have a stoma, there is an opening on the tummy wall with the bowel brought to the surface; a reversed stoma leaves a further small scar. Scars fade over months but remain visible.

⚠ Get urgent help if…

Worsening or severe tummy pain, or a hard, swollen, very tender tummy
A high temperature, chills or feeling very unwell (possible infection or leak)
Redness, swelling, heat or discharge from a wound
A swollen, hot or painful calf, or sudden breathlessness or chest pain (possible blood clot)
Persistent vomiting, or being unable to pass wind or stool
No output into the stoma for a prolonged time, or heavy bleeding
Heavy rectal bleeding or passing large clots

Who to contact: your surgeon or clinic first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.

General guidance — it doesn't replace the specific advice your surgeon gives you.

Results & realistic expectations

A good result is removal of the cancer with clear margins (no cancer cells at the cut edges) and a recovery without major complications. The full picture comes from the pathology report on the removed bowel and lymph nodes, which is usually discussed within a couple of weeks. This shows the type and stage of the cancer, whether it was completely removed, and whether the lymph nodes were affected, all of which guide whether further treatment such as chemotherapy is recommended.

Surgery offers the best chance of cure for bowel cancer that has not spread widely, but it cannot promise the cancer will never return. Outcomes depend strongly on the stage at which the cancer is found. This is why regular follow-up, scans and blood tests are part of the plan, and why any new symptoms should be reported.

How long it lasts

How well surgery controls bowel cancer in the long term depends mainly on the stage of the cancer when it is found, whether it is fully removed, and whether further treatment is needed. Cancer that is found early and removed completely has a much better outlook than cancer that has spread. Follow-up over several years with scans and blood tests aims to pick up any recurrence early. Your team can explain what the figures mean for your situation, but no operation can guarantee the cancer will not come back.

Combining with other procedures

Surgery is often combined with other treatments. Some rectal cancers are treated with radiotherapy or chemotherapy before surgery to shrink the tumour, and some cancers are followed by chemotherapy afterwards to lower the risk of return. A temporary stoma made during surgery may be reversed in a separate, later operation once the bowel has healed.

Follow-up & long-term care

After surgery, the MDT reviews the pathology results and recommends any further treatment and a follow-up plan. This usually includes regular check-ups, blood tests (such as a tumour marker), scans (such as CT) and sometimes further colonoscopies over several years to look for any recurrence. If you have a stoma, your stoma nurse provides ongoing support.

Attend all planned follow-up appointments, scans, blood tests and surveillance colonoscopies.
If you have a stoma, keep up regular reviews with your stoma nurse and reorder supplies in good time.
Report new or returning symptoms — such as bleeding, a change in bowel habit, pain or weight loss — without waiting for the next appointment.
Look after general health with a balanced diet, activity and not smoking, and accept support for emotional wellbeing.

Revision and secondary surgery reality

A temporary stoma often needs a second, later operation to reverse it, and not all stomas can be reversed.
A leak or other complication may mean a return to theatre and sometimes a new or longer-lasting stoma.
Some people need further treatment such as chemotherapy after surgery, decided once the pathology is known.
If cancer recurs, further surgery or other treatment may be considered.

Ask your surgeon for their own revision rate, what counts as a revision, and what is included in the written aftercare policy.

What good aftercare looks like

Care within an enhanced recovery programme and a named contact (such as a colorectal nurse specialist) for problems.
Stoma-nurse support before and after surgery for anyone who may have a stoma.
A clear plan for the pathology results, any further treatment, and structured follow-up with scans and blood tests.
Written warning signs for leak, infection and blood clots, with clear advice on when and how to seek urgent help.
Access to dietitian and emotional or psychological support.

What affects the cost

Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:

The type and complexity of the operation, and whether keyhole, robotic or open surgery is used
Surgeon's and anaesthetist's fees, and the theatre and hospital stay
Higher-dependency or intensive care if needed
Stoma care, supplies and stoma-nurse support if a stoma is formed
Pathology, scans and other tests for staging and follow-up
Any additional treatment such as chemotherapy or radiotherapy
Management of any complications, which can extend the hospital stay

Make sure your written quote includes

The surgeon's and anaesthetist's fees and the hospital or theatre fee
The expected length of stay and the cost if it is longer than planned
Stoma supplies and stoma-nurse support if relevant
Pathology, scans and follow-up appointments
How any further treatment (chemotherapy or radiotherapy) is arranged and funded
What happens, and what it costs, if a complication or further surgery is needed
How care links with the NHS multidisciplinary team and follow-up

On the NHS? Bowel cancer surgery is a core NHS cancer treatment, with the multidisciplinary team, staging and follow-up central to care; private treatment is also available and often runs alongside NHS care.

You're entitled to your total cost in writing — including aftercare and any revision — before you decide.

Choosing a surgeon safely

Check your surgeon is on the GMC Specialist Register for this area.
Make sure they practise at a CQC-registered location, and look for membership of bodies like BAAPS or BAPRAS.
You're entitled to a two-stage consent process with time to reflect (a cooling-off period). The surgeon who will operate must consent you — not a salesperson.
Be wary of pressure: time-limited offers, discounts or deposits taken before you've had time to think are red flags, not bargains.
You're entitled to your total cost in writing — including aftercare and any revision — before you decide.

How Vuemedics verifies every consultant →

Questions to ask your medical professional

Take this to your consultation. A good surgeon will welcome every one of these.

Which operation do you recommend, and will I need a stoma — temporary or permanent?
What stage is my cancer, and will I need chemotherapy or radiotherapy as well?
Can my operation be done by keyhole or robotic surgery, and what is my personal risk?
What is the chance of a leak from the join, and how will it be detected and managed?
Could the surgery affect my bladder or sexual function, especially for rectal cancer?
What does my follow-up involve, and what are the signs the cancer might be coming back?
Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
Will you be the surgeon who carries out my operation, and who looks after me afterwards?
What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
What does a realistic result look like — and what can this operation not achieve?
What are my options, including waiting, doing nothing for now, or choosing a different approach?
Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
What is the total cost in writing, including any follow-ups, and how much time do I have to decide?

Frequently asked questions

Will I need a stoma?

It depends on the operation and where the cancer is. Many people do not need one, some need a temporary stoma to protect a join, and a few need a permanent one, mainly for cancers very low in the rectum. Your surgeon should tell you what is likely, and you can usually meet a stoma nurse beforehand.

Is the cancer cured after surgery?

Surgery offers the best chance of removing bowel cancer that has not spread widely, but no operation can guarantee the cancer will never return. The pathology report and follow-up help judge the outlook, which depends a lot on the stage. Some people also need chemotherapy or radiotherapy.

How long will I be in hospital?

Often several days. Keyhole surgery with an enhanced recovery programme can mean going home within a week, sometimes sooner; open surgery or complications can mean longer.

How long does it take to recover?

Many people feel much better within about six weeks but take up to around three months to feel fully recovered, and longer if there are complications or further treatment. Bowel habit can take time to settle.

Will my bowels be normal afterwards?

Bowel habit is often looser, more frequent or more urgent at first, especially after rectal surgery, and usually improves over months. Some people have lasting changes, which your team can help you manage.

What is keyhole or robotic surgery, and is it better?

These use small cuts and a camera (and, for robotic, surgeon-controlled instruments). They can mean a quicker recovery and shorter stay for suitable people, with similar cancer outcomes, but they are not right for every tumour.

Can I have this done privately?

Bowel cancer surgery is a core NHS treatment. Some people choose private care for speed or choice; the MDT discussion, staging and follow-up remain just as important in either setting.

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How we made this page

Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →

Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.

Sources & standards: NHS — Bowel cancer: treatment Bowel Cancer UK — Types of surgery NICE NG151 — Colorectal cancer: diagnosis and management Cancer Research UK — Bowel cancer survival StatPearls (NCBI) — Hemicolectomy Risk factors for anastomotic leakage after colorectal surgery — review (PMC) Bowel cancer statistics — Cancer Research UK

Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.

Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.