The Cambridge Colorectal Unit is part of the Department of General Surgery at Addenbrooke's. The Cambridge Colorectal Unit aims to provide a comprehensive specialist service to care for patients with all colorectal (large bowel and rectal) disorders. Patients will be guided by a dedicated team of doctors, specialist nurses and allied professionals through their encounter with the Unit from their first clinic visit, to surgery (if required) and then follow-up.
Conditions treated by the team include: anal fissures, anal fistulas, bowel polyps, rectal prolapse, colorectal cancer (cancer of the colon and rectum), diverticular disease, haemorrhoids (piles), incontinence, inflammatory bowel disease (colitis and Crohn's), minor anal conditions: skin tags, fibroepithelial polyps, external haemorrhoids, warts, pilonidal sinus and pruritus ani (anal itchiness).
Many patients can be diagnosed and treated in the clinic. For example, most patients with haemorrhoids are suitable for outpatient treatment. Other patients will require investigations, and we have access to the full range of specialist investigations for colorectal diseases.
The Stoma team are dedicated to providing high quality, expert care to new and established stoma and ileo-anal pouch patients.
Our care ranges from across neonatal, paediatrics and adult patients within both inpatient and outpatient settings.
We see patients requiring
- stoma formation
- reconstructive bowel surgery
- management of enterocutaneous fistulae (abnormal connections between the intestine and the surface of the skin)
- Ileo-anal pouch surgery
- Ace procedure
The aim of the nursing service
The nursing service provides an informative and supportive service to all our patients with either a stoma, enterocutaneous fistula or internal pouch.
This will begin when you meet your specialist nurse, usually before surgery. You will be given information regarding your surgery and the ideal site for your stoma will be selected. On admission to the hospital, your specialist nurse will talk to you about whether you have understood this information and discuss any questions or anxieties you may have.
After your operation you will be shown how to care for your stoma, including how to empty and change the appliance independently. You will be given information regarding your diet, ongoing supplies, returning to work, common problems and much more. If you are a local patient, you will be followed up in the stoma clinic two weeks after you are discharged.
If you live outside the area then you will be referred to a stoma care nurse based in your area, who will provide ongoing support.
Non-urgent advice: Information for patients
2 week wait suspected cancer service Patients with suspected colorectal cancer will be referred by their GP to the 2ww LGI suspected cancer service.
This is a nurse led service where patients are triaged as straight to test or assessed in clinic by a trained clinical nurse specialist and investigations arranged accordingly on a fast track pathway. Clinic or investigations will be within 2 weeks of GP referral.
If no cancer is found, patient will be notified within 28days. Any non-clinical urgent incidental findings found during diagnostic investigation process will be discharged back to their GP with appropriate recommendations.
When a diagnosis of cancer is made, treatment for each patient is discussed by a multidisciplinary team of cancer experts including colorectal surgeons, radiologists, histopathologists, oncologists and specialist nurses, all of whom play a part in supporting patients and family through their cancer journey. This is to ensure care is determined on an individual basis and tailored to specific patient’s needs.
Patients with colorectal cancer that has not spread are considered for surgery. Patients with anal cancer, on the other hand, are usually treated with a combination of chemotherapy and radiotherapy. Radiotherapy and chemotherapy before surgery is also sometimes advised for patients with rectal cancer. Chemotherapy given after surgery may also be of benefit. Patients with inoperable or metastatic disease will be considered for chemotherapy and maybe radiotherapy.
In general, the management of lower gastrointestinal cancers depends on the presenting stage of disease and patient fitness.
After cancer surgery/ Surveillance
The decision for colorectal cancer surveillance is determined by the multidisciplinary team once final histology is reviewed. After cancer surgery, follow-up is co-ordinated by our specialist nursing staff, which counsel patients and arrange investigations and run nurse clinic follow up. The nurse specialists are available at the end of the telephone or face to face with any colorectal cancer patient who has concerns about their diagnosis, treatment, recovery and living life with or beyond cancer.
The Stoma care nursing Service is designed to meet the needs of people who are undergoing bowel surgery which has resulted in a stoma and long term support/advice as needed.
We aim to support in the following ways: Giving pre operative information regarding surgery, enhanced recovery and stoma formation stoma siting teaching practical stoma care supporting patient and carers in adjusting to life with a stoma ongoing telephone support and clinic reviews.
The majority of patients are referred by their general practitioner (GP), and are initially seen in the outpatient clinic. Others will be referred by hospital consultants, or are admitted through the Emergency Department