Colorectal Oncology

Rectal Cancer

Sphincter-preserving surgery for rectal cancer using total mesorectal excision — restoring bowel function and quality of life.

Understanding Rectal Cancer

Rectal cancer arises in the last 15 cm of the large bowel. Modern treatment combines neoadjuvant chemoradiation with total mesorectal excision (TME), allowing sphincter preservation in most cases. Dr. Abhishek Aggarwal performs laparoscopic and robotic TME with excellent functional outcomes.

Presents with bleeding, tenesmus or change in bowel habit
Staging uses MRI pelvis and CT abdomen
Treatment is often neoadjuvant chemoradiation followed by TME
Sphincter preservation is possible in 70-80% of cases

TMETotal Mesorectal Excision

80%Sphincter Preservation

RoboticPrecision Approach

MDTTumour Board

Frequently Asked Questions

What are the symptoms of rectal cancer?

Bright red rectal bleeding, tenesmus (feeling of incomplete evacuation), change in bowel habit, narrow stools and pelvic pain. Bleeding should never be dismissed as ‘just piles’.

How is rectal cancer staged?

High-resolution MRI of the pelvis is the gold standard for local staging. CT chest/abdomen/pelvis and CEA complete the work-up.

What is TME (Total Mesorectal Excision)?

TME is the oncological standard for rectal cancer — removal of the rectum along with its complete envelope of fatty tissue and lymph nodes (mesorectum) in the correct surgical plane.

Will I need a permanent stoma?

For most rectal cancers a permanent stoma can be avoided. Only very low tumours involving the anal sphincter need an abdominoperineal resection with permanent colostomy.

What is neoadjuvant chemoradiation?

This is chemotherapy combined with radiotherapy given before surgery to shrink the tumour, improve chances of clear margins and enable sphincter preservation.

What is ‘watch and wait’?

Selected patients who achieve a complete clinical response after chemoradiation can be observed without surgery. This requires a specialised multidisciplinary team and close surveillance.

Is robotic rectal cancer surgery better?

Robotic TME offers superior visualisation in the narrow pelvis, potentially better functional outcomes (urinary and sexual function) and equivalent oncological results.

Will I have a temporary stoma?

A temporary loop ileostomy is common after low anterior resection to protect the anastomosis. It is closed after 8-12 weeks.

How is bowel function after rectal surgery?

Most patients experience some ‘low anterior resection syndrome’ initially — frequency, urgency, clustering. This improves significantly over 6-12 months with pelvic floor exercises and diet.

What are the long-term outcomes?

Stage I-II rectal cancer has 80-90% 5-year survival. Stage III with modern multimodal treatment achieves 60-75%. Quality of life outcomes are excellent with specialist care.

Dr. Abhishek Aggarwal — Senior Consultant GI & HPB Oncosurgeon, BLK-Max Delhi

Meet Dr. Abhishek Aggarwal

12+ Years Experience500+ Cancer SurgeriesBLK-Max Delhi

Dr. Abhishek Aggarwal is a highly skilled GI & HPB surgeon with over 10 years of experience in managing complex gastrointestinal and hepato-pancreato-biliary diseases, with a special focus on oncological surgery. He currently serves as Associate Director – GI Oncosurgery at BLK-Max Super Speciality Hospital, where he is actively involved in delivering advanced surgical care for GI and HPB malignancies.

He has trained and worked in reputed high-volume centres, gaining extensive expertise in complex oncological procedures and multidisciplinary cancer care. His clinical practice is firmly grounded in scientific, evidence-based medicine, ensuring that patients receive treatment aligned with the latest global standards and research.

OPD Timing: 09:00 AM – 05:00 PM

Contact Dr. Abhishek →