Laparoscopic Surgery – Rectal Cancer Treatment Replete With Safety, Efficacy And Minimal Invasion

Laparoscopic surgery that has been around for nearly two decades for treating intestinal disorders, however its positive aspects has only lately been employed in treating rectal cancer patients. In a forthcoming study involving 103 candidates that undertook basic or ‘hand-aided’ laparoscopic surgery for treating rectal cancer, a group of colon and rectal surgeons from the NewYork-Presbyterian Hospital/Weill Cornell Medical Center have illustrated that the minimally invasive technique could be as effectual as conventional open surgical intervention for rectal cancer treatment.

The benefits of laparoscopic and other minimal invasive operative approaches are widely acknowledged. Subsequent to laparoscopic surgery there are briefer hospitalization, lesser pain endured and swifter recuperation. NewYork-Presbyterian/Weill Cornell have been offering these techniques since long, and are continuing to be vanguards of improvement, using the minimally invasive technique to ailments and conditions that were earlier deemed curable solely through open surgery approach. Till lately, rectal cancer was one such ailment and treating it through laparoscopic surgery continues to be debatable.

Dr. Jeffrey Milsom, chief of colon and rectal surgery from the NewYork-Presbyterian/Weill Cornell stated that rectal surgery is intrinsically more complicated as compared to colon surgery. As the pelvic space of the body where the rectum is located is a tapered cavity that makes rectal tumors quite inaccessible. Operative success is dependent on not just the total extraction of the malignant tumor and repairing the rectum, but also on reinstating continence. Hence due to these grounds, rectal cancer has been a tricky ground for application of advancements in minimally invasive surgery.

The preliminary reports on the usage of laparoscopic surgery among patients with rectal cancer illustrated an increased occurrence of cancer-positive cells present at the periphery of the extracted tumors when evaluated against open surgery. The surfacing of these reports has lead to matters getting postponed further. Former data implied that as an outcome, more number of patients’ cases could undergo a local relapse of rectal cancer subsequent to laparoscopic surgery as compared to open surgery. However, the present study rebuts these preliminary findings.

In between January 1999 – December 2006, 3 colon and rectal surgeons namely Dr. Milsom along with his associates Dr. Toyooki Sonoda and Dr. Sang Lee carried out treatment on 103 patients having central or lower rectal cancer employing a surgery known as total mesorectal excision (TME), conducted through laparoscopic-assisted (LAP)or hand-assisted laparoscopic (HALS). To collect pertinent information and investigate results, Dr. Milsom and his group depended on in-patient and out-patient medical documentation, telephonic interrogations with patients and benchmark actuarial survival computations. Regular follow-ups for these patients were done till 5 years.

Dr. Sonoda, one among the chief surgeons of the study proclaimed that these results were at par with the best results noted in open surgical approaches for cancer treatment and recovery. He further added that when one sums in all the benefits of laparoscopic surgery, it appears distinctly obvious that this is a technique that has the potential to develop into the surgical benchmark.

Accounted for in the initial part of the present year in the specialized academic journal of the American Society of Colon & Rectal Surgeons, the study was carried out in one organization. This detail alongside its moderately small-sized sample, dearth of randomization and comparatively squat follow-up time period all suggest the requirement of large-size, randomized researches prior to the discoveries being deemed ideal.

Dr. Milsom cited that his operative team is presently partaking in two similar studies, one in partnership with the American College of Surgeons Oncology Group or ACSOG.

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