Division of Colorectal Surgery at NUH provides expert care for a spectrum of colorectal conditions, from benign ailments like anal pain, haemorrhoids, and anal fissures, to malignant conditions such as colorectal cancer and rectal cancer. We focus on early detection, personalised treatment plans, and advanced surgical solutions tailored for each patient.
We are committed to provide you with comprehensive and personalised care, ensuring that both you and your loved ones receive a customised treatment tailored specifically for your needs.
If you or your loved ones have a confirmed diagnosis of colorectal cancer and wish to seek a second opinion, do contact us at our appointment line (+65 6908 2222).
Our commitment is to schedule consultations with one of our specialists for all second opinion requests within 1 working day.
Our consultant-led clinics operate from Monday to Friday, and your care will be managed by our dedicated specialists.
While early-stage colorectal cancer often has no noticeable symptoms, it's crucial to be aware of potential warning signs. Please seek immediate medical attention if you experience any of the following symptoms:
Early detection is key in cancer treatment, so it's always better to err on the side of caution.
Colorectal cancer, while a serious health concern, is influenced by various risk factors that can increase an individual's likelihood of developing the disease. These risk factors encompass a range of elements, from uncontrollable aspects like age and genetic predisposition to lifestyle choices that can be modified. Understanding these risk factors is crucial for both prevention and early detection of colorectal cancer.
High-risk groups for colorectal cancer include:
It's crucial to discuss your individual risk factors with your healthcare provider. They can help determine if you need colorectal cancer screening.
Click here to schedule an appointment with us.
Colorectal cancer is curable if detected early. However, individuals with colon polyps or early colon cancer may not display any symptoms. We encourage all patients above the age of 50 to undergo regular colorectal cancer screening. There are two common screening methods in Singapore.
Faecal Immunohistochemical Test (FIT)
The FIT is designed to detect blood in the stool that might not be visible to the naked eye. The FIT kit comes with a stick used to collect a small sample of stool. This test is not suitable if you are already passing blood in your stools.
Colonoscopy
A colonoscopy is the 'gold standard' for colorectal cancer screening. The doctor uses an endoscope—a flexible tube with a camera—to evaluate the inner lining of the colon and rectum. During the colonoscopy, any identified polyps or areas of concern are removed and sent for microscopic evaluation. This serves a dual purpose of both diagnosing any potential issues and providing therapeutic intervention, as some polyps have the potential to develop into cancer.
Normal bowel movements differ between people. Some may have up to three bowel movements a day, while others may go days between movements. Constipation can result from various factors like insufficient water intake, low fibre consumption, and lack of physical activity. Additionally, medical conditions such as high calcium levels or hormonal imbalances might contribute to constipation.
Diarrhoea is most commonly due to benign causes, such as a viral infection (gastroenteritis) or lactose intolerance, and is particularly common among Asians. However, persistent diarrhoea should prompt evaluation for more serious underlying causes, such as chronic infectious causes, inflammatory bowel disease and spurious diarrhoea from colorectal cancer.
If you have new-onset constipation that is persistent, you should undergo evaluation, including colonoscopy for colorectal cancer.
Pain around the anus commonly occurs due to anal fissures, which are traumatic tears around the anus due to the passage of hard stools. Treatment usually includes stool softeners, painkillers and medication to relieve the associated spasm in the anal sphincter muscles.
Pain around the anus may also be due to prolapsed or thrombosed haemorrhoids. These are initially treated with stool softeners and topical anaesthetic agents, while surgery may be indicated once the acute event has settled down.
Anal pain associated with discharge and fever may indicate perianal abscesses or anal fistulas. These can be treated with antibiotics but may require surgery for definitive management.
Faecal incontinence can be a distressing symptom as it may manifest as passive seepage of solid or liquid stools or an inability to reach the toilet in time during periods of urgency. Incontinence is commonly associated with a history of obstetric trauma or previous anal surgery.
The Division of Colorectal Surgery offers an extensive range of up-to-date medical treatment, clinic-based therapies and surgical procedures to our patients.
Minimally Invasive Surgery
Laparoscopic (keyhole) surgery: This approach involves small incisions in the abdomen using special instruments under general anaesthesia. It is an advanced technique that avoids the need for large incisions, reducing post-operative discomfort, minimising the risk of wound infections and shortening hospital stays.
Robotic surgery: This method involves small incisions in the abdomen and the use of surgeon-controlled robotic arms under general anaesthesia. The benefits are similar to those of laparoscopic surgery.
Transanal Surgery
Transanal Minimally Invasive Surgery (TAMIS) uses a specialised platform to remove growths from the mid to upper rectum. It eliminates the need for major abdominal surgery for large polyps or early rectal cancers.
Transanal Total Mesorectal Excision (taTME) is a novel surgical approach for the treatment of rectal cancer. Two surgical teams work in tandem, using a combined abdominal and transanal approach to remove low rectal cancers.
Advanced Endoscopy
Previously, large colon polyps required a resection of the colon for complete removal. These days, advanced endoscopic resection techniques such as Endoscopic Mucosal Resection (EMR) and Endoscopic Submucosal Dissection (ESD) allow patients to avoid surgery.
Cytoreductive Surgery (CRS) and Heated Intra-peritoneal Chemotherapy (HIPEC)
Patients with advanced cancers affecting the peritoneum may be treated with CRS and HIPEC, which involve the resection of all visible cancer and delivery of heated chemotherapy directly into the abdominal cavity.
Pressurised Intra-Peritoneal Aerosolised Chemotherapy (PIPAC)
PIPAC is a novel, promising technology for the treatment of patients with advanced peritoneum cancer. Chemotherapy is administered in an aerosolised form into the abdominal cavity using laparoscopic (keyhole) techniques.
Associate Professor Tan Ker Kan
Head of Division
Senior Consultant
A/Prof Tan specialises in both minimally invasive procedures for primary and recurrent colorectal cancer and complex colorectal conditions, with a keen interest in proctology work especially in anal fistula and haemorrhoids.
Specialties: Colorectal Surgery, Surgical Oncology (Colorectal Surgery)
Clinical Interest: Colorectal cancer, Keyhole/Laparoscopic surgery, Anal fistula, Haemorrhoids, Anal fissure, Colonoscopy, Recurrent colon and rectal cancer, Colorectal polyps
Languages Spoken: English, Mandarin, Hokkien, Malay (simple)
Adjunct Associate Professor Cheong Wai Kit
Senior Consultant
Adj Assoc Prof Cheong has vast experience in the management of diseases of the colon, rectum and anal canal, with special interest in advanced and recurrent colorectal cancer, abdominal and pelvic sarcoma, peritoneal cancer, and complex anal fistula.
Specialties: Colorectal Surgery, Surgical Oncology (Colorectal Surgery)
Clinical Interest: Minimally Invasive Colorectal Surgery, Recurrent and Advanced Colorectal Cancer, Pelvic Exenteration, Peritoneal Cancer, Abdominal and Pelvic Sarcoma, Complex Anal Fistula
Languages Spoken: English, Chinese, Malay, Cantonese
Adjunct Associate Professor Bettina Lieske
Senior Consultant
Adj Assoc Prof Bettina specialises in peritoneal malignancies, with extensive experience in cytoreductive surgery and heated intra-peritoneal chemotherapy. She is dedicated to providing personalised care and achieving the best possible outcomes for her patients.
Specialties: Colorectal Surgery, Surgical Oncology, Surgical Oncology (Colorectal Surgery) )
Clinical Interest: Diagnostic and Therapeutic Endoscopy (Gastroscopy and Colonoscopy), Laparoscopic Surgery for Colorectal Cancer and Benign Colorectal Conditions, Malignant Peritoneal Disease (Including Neoplasms of the Appendix & Pseudomyxoma Peritonei), Cytoreductive Surgery and Heated Intraperitoneal Chemotherapy (CRS and HIPEC), Pressurised Intraperitoneal Aerosolised Chemotherapy (PIPAC)
Languages Spoken: English, German
Adjunct Associate Professor Ian Tan
Consultant
Adj Assoc Prof Tan specialises in advanced laparoscopic (key-hole) colorectal surgery for cancer as well as inflammatory bowel disease. In addition to being an advanced endoscopist (colonoscopy and gastroscopy), he also specializes in the management of haemorrhoids, anal fistula and anal fissures.
Specialties: Colorectal Surgery
Clinical Interest: Colorectal Cancer, Diagnostic and Therapeutic Endoscopy (Gastroscopy and Colonoscopy), Minimally Invasive Surgery, Inflammatory Bowel Disease (Ulcerative Colitis and Crohn's Disease)
Languages Spoken: English, Mandarin, Malay
Adjunct Assistant Professor Norman Lin
Consultant
Adj Asst Prof Lin is a Colorectal and Trauma Surgery specialist with expertise in robotic and advanced surgical techniques, offering comprehensive care for colorectal conditions and traumatic injuries.
Specialties: Colorectal Surgery, Trauma Surgery
Clinical Interest: Colorectal Cancer, Laparoscopic Colorectal Surgery, Robotic Colorectal Surgery, Colonoscopy, Benign Coloproctology Diseases
Languages Spoken: English, Mandarin, Hokkien
Adjunct Assistant Professor Dedrick Chan
Consultant
Adj Asst Prof Chan is an established colorectal surgeon with extensive experience. His clinical focus is on colorectal cancer and he delivers surgical care aimed at improving cancer outcomes.
Specialties: Colorectal Surgery
Clinical Interest: Colorectal Cancer, Laparoscopic Surgery, Minimally Invasive Techniques, Haemorrhoids/Piles, Anal Fistula, Advanced Colonoscopy
Languages Spoken: English, Mandarin, French
Adjunct Assistant Professor Lee Kai Yin
Consultant
Adj Asst Lee specialises in minimally invasive robotic and laparoscopic techniques for colorectal cancer treatment, with expertise in surgery, research, and medical education.
Specialties: Colorectal Surgery, Surgical Oncology (Colorectal Surgery)
Clinical Interest: Colorectal Cancer, Minimally Invasive/Robotic Surgery, Colonoscopy, Haemorrhoids
Languages Spoken: English, Mandarin
Dr Bryan Buan Jun Liang
Consultant
Dr Buan specialises in minimally invasive techniques and colorectal cancer treatment, with a strong focus on early detection and patient education.
Specialties: Colorectal Surgery, Surgical Oncology (Colorectal Surgery)
Clinical Interest: Colorectal Cancer, Minimally Invasive Surgery, Diagnostic and Therapeutic Endoscopy, Haemorrhoids. Anal Fistulas
Languages Spoken: English, Mandarin
Dr Jarrod Tan Kah Hwee
Consultant
Dr Tan specializes in colorectal surgery, with advanced expertise in minimally invasive techniques and the management of recurrent or advanced colorectal cancers and abdominopelvic sarcomas.
Specialties: Colorectal Surgery, Surgical Oncology (Colorectal Surgery), Minimally Invasive Surgery
Clinical Interest: Minimally Invasive Colorectal Surgery, Recurrent and Advanced Colorectal Cancer, Pelvic Exenteration, Peritoneal Cancer, Abdominal and Pelvic Sarcoma, Complex Anal Fistula
Languages Spoken: English, Chinese & Hokkien
Dr Lim Tian Zhi
Associate Consultant
Dr Lim is committed to public health education with a focus on colorectal cancer screening and its associated health services.
Clinical Interest: Colorectal Cancer Screening, Public Health
Languages Spoken: English, Mandarin, Hokkien
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We are committed to providing world-class care for our patients undergoing laparoscopic colon resections and laparoscopic rectal resections. To ensure the highest standards, we regularly compare our performance against international benchmarks. Below are our results in key areas:
| NUH (2020 up to 2024 Q2) | International Benchmarks 1-5 | |
|---|---|---|
| Anastomotic leak | 1.3% | 4% - 7% |
| Conversion to open surgery | 1.6% | 0% - 6% |
| Wound infection | 1.3% | 0% - 4% |
| Thromboembolic rates | 0% | 1.5% - 4.3% |
| Severe complications (Clavien Dindo ≥3) | 1.2% | 1% - 8.8% |
| Length of stay (days) | 5.7 | 3 - 8 |
| Readmission rates | 1.2% | 0% - 7.3% |
| Mortality | 0% | 0% - 3.5% |
References:
1. Staiger, R. D., Rössler, F., Kim, M. J, et al. (2022). Benchmarks in colorectal surgery: multinational study to define quality thresholds in high and low anterior resection. The British journal of surgery, znac300. Advance online publication. https://doi-org.libproxy1.nus.edu.sg/10.1093/bjs/znac300
2. Wang, Y., Deng, H., Mou, T. et al. Short-term outcomes of single-incision plus one-port laparoscopic versus conventional laparoscopic surgery for rectosigmoid cancer: a randomized controlled trial. Surg Endosc 33, 840-848 (2019).
3. Peltrini, R., Imperatore, N., Carannante, F. et al. Age and comorbidities do not affect short-term outcomes after laparoscopic rectal cancer resection in elderly patients. A multi-institutional cohort study in 287 patients. Updates Surg 73, 527-537 (2021). https://doi.org/10.1007/s13304-021-00990-z
4. Hayes, J. W., Ryan, É. J., Boland, P. A., Creavin, B., Kelly, M. E., & Beddy, D. (2019). The prevalence of venous thromboembolism in rectal surgery: a systematic review and meta-analysis. International journal of colorectal disease, 34(5), 849-860. https://doi.org/10.1007/s00384-019-03244-y
| NUH (2020 up to 2024 Q2) | International Benchmarks 4-7 | |
|---|---|---|
| 1.2% | 9.8% | |
| Conversion to open surgery | 1.2% | 7.6% |
| Wound infection | 3.1% | 0.9% - 2.6% |
| Thromboembolic rates | 0% | 1.5% - 4.3% |
| Severe complications (Clavien Dindo ≥3) | 3.0% | 12.2% |
| Length of stay (days) | 6.0 | 4 - 10 |
| Readmission rates | 6.7% | 15.3% |
| Mortality | 1.5% | 0% - 3.7% |
References:
5. Ali, F., Al-Kindi, S. G., Blank, J. J., Peterson, C. Y., Ludwig, K. A., & Ridolfi, T. J. (2018). Elevated Venous Thromboembolism Risk Following Colectomy for IBD Is Equal to Those for Colorectal Cancer for Ninety Days After Surgery. Diseases of the colon and rectum, 61(3), 375-381. https://doi.org/10.1097/DCR.0000000000001036
6. Bollo, J., Turrado, V., Rabal, A., et al. (2020). Randomized clinical trial of intracorporeal versus extracorporeal anastomosis in laparoscopic right colectomy (IEA trial). The British journal of surgery, 107(4), 364-372. https://doi.org/10.1002/bjs.11389
7. Cleary, R.K., Silviera, M., Reidy, T.J. et al. (2022). Intracorporeal and extracorporeal anastomosis for robotic-assisted and laparoscopic right colectomy: short-term outcomes of a multi-center prospective trial. Surg Endosc 36, 4349-4358. https://doi.org/10.1007/s00464-021-08780-9
As part of the Division's pursuit of excellent patient-centric care, we have integrated Patient Reported Outcome Measures (PROMS) into our clinical care model. The outcomes you care about are our top priority and is woven into how we treat and care for you.
Care for Seniors -
Our surgeons are highly experienced in providing care and treating elderly patients. We aim to provide the best geriatric care possible. Our PROMS study shows that elderly patient under our care experience good post-surgery recovery in these 6 various domains.
| 1. General quality of life | 2. Physical functioning | 3. Role functioning |
| 4. Emotional functioning | 5. Cognitive functioning | 6. Social functioning |
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TCI = red line represents Threshold of Clinical Importance (see Giesinger et al. 2020; https://www.sciencedirect.com/science/article/pii/S0895435619307085
Scoring below the TCI value means that the patient is likely to be having a health problem relevant to the clinical encounter.
Click on the titles below to find out more.
Young patients with colorectal cancer face unique physical, emotional and psychosocial impact
14 October 2022
The Straits Times © SPH Media Limited. Reproduced with permission
25 March 2021
Health Matters - Colorectal Cancer FIT Screening
A/Prof Tan Ker Kan, Head & Senior Consultant discussed about colorectal cancer screening and his two studies on the behaviour and attitudes of individuals with positive FIT results towards colorectal cancer screening.
16 March 2021
The Straits Times © SPH Media Limited. Reproduced with permission
Our patients shared their stories on their journey with colorectal cancer:
26 March 2022 - NUH Colorectal Public Webinar
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25 September 2021 - NUH Colorectal GP CME Webinar
27 March 2021 - NUH Colorectal Public Webinar
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20 March 2021 - NUH Colorectal GP CME Webinar
The NUH Division of Colorectal Surgery offers a Clinical Fellowship in Colorectal Surgery for clinicians interested in gaining exposure and deepening clinical expertise in Colorectal Surgery. Up to two fellowship positions are available per year, with a specialised training programme of 12 months. More details can be found here.
For enquiries, please email [email protected] with the subject header “Colorectal Fellowship” addressed to Adj Assoc Prof Bettina Lieske. For more information about the application process for NUHS Clinical Fellowships, please click here.
Insurance
Our surgeons are included in all major Singapore insurance panels. You may find out more from our Financial Counselling staff during your visit to us.
Estimated Charges
Below estimates are for Class A / Foreign patients following an uncomplicated post-operative recovery. Class B and C patients enjoy further government subsidies; you may find out more during your Financial Counselling visit to us.
| Estimated Total Bill Size for Singaporean (5 day stay) | |
| Laparoscopic Colon Resection | $32,142.00 - $40,644.00 |
| Laparoscopic Rectal Resection | $47,281.00 - $57,745.00 |
| Estimated Total Bill Size for Non-Resident (5 day stay) | |
| Laparoscopic Colon Resection | $40,270.00 - $50,303.00 |
| Laparoscopic Rectal Resection | $60,147.00 - $72,494.00 |
Disclaimer: Information is reflected correctly as at 14 February 2025. For more information, click here.
Location
NUH Medical Centre, Zone B, Level 16
Opening Hours
Mon - Fri: 8.30am to 5.30pm
Sat, Sun & PH: Closed
Contact
+65 6908 2222 (general appointment line)
+65 6772 2230
+65 9829 7313 (For Whatsapp text messages only)
For booking of appointment with the surgeon of your choice, please click here to make an appointment.
Disclaimer: Appointments and referrals made directly through Colorectal Centre's website will not be eligible for government subsidies. For more information on subsidy eligibility, please visit moh.gov.sg
