scholarly journals Laparoscopic versus open surgery in the treatment of colorectal cancer

2021 ◽  
Vol 9 (1) ◽  
pp. 256
Author(s):  
Yasser Mohammad Abd-Elshafy ◽  
Islam Mohammad Mohammad ◽  
Hazem Nour Abdelatif Ashry ◽  
Mohammad Abdullah Zaitoun
Keyword(s):  
Colorectal Cancer ◽  
Rectal Cancer ◽  
Open Surgery ◽  
Laparoscopic Resection ◽  
Phase Iii ◽  
Curative Treatment ◽  
Invasive Approach ◽  
Colon And Rectal Cancer ◽  
Study Results ◽  
Surgeon Experience

Because of the initial case study results suggesting high recurrence rates at port sites, adoption of the laparoscopic approach for colorectal cancer treatment was slow. Surgical resection remains the cornerstone and most important facet in management of colon cancer. The use of minimally invasive approach in colorectal surgery has been reported by several authors in the literature. Some difficult about the use of laparoscopic surgery for colorectal cancer still raises, particularly with the technique’s complexity, learning curve and longer duration. Scientific literature published from January 2010 to April 2020 was reviewed. Phase III randomized clinical trials were included. Analysis of the scientific literatures confirmed that for the curative treatment of colon and rectal cancer, laparoscopy is not inferior to open surgery with respect to overall survival, disease-free survival and rate of recurrence. Laparoscopic resection can be considered an option for the curative treatment of colon and rectal cancer; but must take into consideration surgeon experience, tumour stage and potential contraindications; and that laparoscopic resection for rectal cancer be performed only by appropriately trained surgeons.

scholarly journals Parameters of radical resection in laparoscopic and open colon and rectal cancer surgery

2020 ◽  
Vol 77 (5) ◽  
pp. 532-538
Author(s):  
Igor Krdzic ◽  
Marko Kenic ◽  
Milena Scepanovic ◽  
Ivan Soldatovic ◽  
Jelena Ilic-Zivojinovic ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Rectal Cancer ◽  
Lymph Nodes ◽  
Open Surgery ◽  
Rectal Surgery ◽  
Laparoscopic Approach ◽  
Resection Margins ◽  
Rectal Cancer Surgery ◽  
Open Approach ◽  
Colon And Rectal Cancer

Background/Aim. In colon and rectal cancer surgery, resection is considered radical when circumferential, proximal and distal resection margins are without the presence of tumor cells. Concept of total mesorectal excision in rectal surgery involves complete removal of the tumor with mesorectal fascia which surrounds lymph nodes, lymphatics and blood vessels. The aim of this study was to determine whether laparoscopic approach provides all parameters of oncological radicality as open surgery of colorectal cancer. Methods. The study included 122 patients with carcinoma of colon and rectum, divided into two equal groups: patients operated on by laparoscopic and those operated on by open approach. In colon surgery we analyzed proximal and distal resection margins, and the number of removed lymph nodes, and in rectal surgery: proximal, distal and circumferential resection margins, and the number of removed lymph nodes. Results. Both groups were comparable in age, sex, American Society of Anesthesiologists (ASA) score, tumor localization, tumor size, and type of surgical operation performed. According to localization of the tumor, the most commonly performed operation was anterior resection of the rectum (60.7% vs. 59%). There was no case of the tumor involvement of the distal margin. Average proximal distance from the tumor on the fixed specimen was 100 vs. 120 mm with statistical significance (p < 0.001). Distal margins were not significantly different, 40 mm in both groups (p = 0.143). In two cases we had circumferential resection margin (CRM) of 1 mm (7.7%) in the laparoscopic group, and in three cases operated conventionally CRM was 1 mm (8.8%). The average number of removed lymph nodes was 15 vs. 16, respectively. Length of hospital stay for patients assigned to the laparoscopic surgery was significantly shorter than for patients operated on by the open approach. Concerning postoperative complications, no significant difference was found between groups. The overall postoperative morbidity was 18% vs. 21.3%, respectively. Conclusion. With laparoscopic approach it is possible to provide all parameters of oncological radicality similarly to the open surgery of colorectal cancer.

scholarly journals German oncology certification system for colorectal cancer – relative survival rates of a single certified centre vs. national and international registry data

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Maximilian Richter ◽  
Lena Sonnow ◽  
Amir Mehdizadeh-Shrifi ◽  
Axel Richter ◽  
Rainer Koch ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Rectal Cancer ◽  
International Comparison ◽  
Cancer Registry ◽  
Survival Data ◽  
Survival Rates ◽  
Relative Survival ◽  
Registry Data ◽  
Cancer Registry Data ◽  
Colon And Rectal Cancer

Abstract Objectives To evaluate how the certification of specialised Oncology Centres in Germany affects the relative survival of patients with colorectal cancer (CRC) by means of national and international comparison. Methods Between 2007 and 2013, 675 patients with colorectal cancer, treated at the Hildesheim Hospital, an academic teaching hospital of the Hannover Medical School (MHH), were included. A follow-up of the entire patient group was performed until 2014. To obtain international data, a SEER-database search was done. The relative survival of 148,957 patients was compared to our data after 12, 36 and 60 months. For national survival data, we compared our rates with 41,988 patients of the Munich Cancer Registry (MCR). Results Relative survival at our institution tends to be higher in advanced tumour stages compared to national and international cancer registry data. Nationally we found only little variation in survival rates for low stages CRC (UICC I and II), colon, and rectal cancer. There were notable variations regarding relative survival rates for advanced CRC tumour stages (UICC IV). These variations were even more distinct for rectal cancer after 12, 36 and 60 months (Hildesheim Hospital: 89.9, 40.3, 30.1%; Munich Cancer Registry (MCR): 65.4, 28.7, 16.6%). The international comparison of CRC showed significantly higher relative survival rates for patients with advanced tumour stages after 12 months at our institution (77 vs. 54.9% for UICC IV; raw p<0.001). Conclusions Our findings suggest that patients with advanced tumour stages of CRC and especially rectal cancer benefit most from a multidisciplinary and guidelines-oriented treatment at Certified Oncology Centres. For a better evaluation of cancer treatment and improved national and international comparison, the creation of a centralised national cancer registry is necessary.

Practice Guideline for the Surveillance of Patients After Curative Treatment of Colon and Rectal Cancer

2015 ◽  
Vol 58 (8) ◽  
pp. 713-725 ◽  
Author(s):  
Scott R. Steele ◽  
George J. Chang ◽  
Samantha Hendren ◽  
Marty Weiser ◽  
Jennifer Irani ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Practice Guideline ◽  
Curative Treatment ◽  
Colon And Rectal Cancer

Radiographic Staging of Colorectal Cancer

2019 ◽  
Author(s):  
Maurits P. Engbersen ◽  
Max J. Lahaye ◽  
Regina G.H. Beets-Tan
Keyword(s):  
Magnetic Resonance Imaging ◽  
Colorectal Cancer ◽  
Computed Tomography ◽  
Rectal Cancer ◽  
Magnetic Resonance ◽  
Tumor Staging ◽  
Tnm Staging ◽  
Preoperative Imaging ◽  
Resonance Imaging ◽  
Colon And Rectal Cancer

Imaging increasingly plays an important role in selecting the most optimal treatment for patients with colon and rectal cancer. While in colon cancer, computed tomography (CT) remains the modality of choice for local and distant staging, in patients with rectal cancer magnetic resonance imaging (MRI) is the main modality and mandatory for local staging. Endoluminal rectal ultrasound (ERUS) is the preferred staging method for superficial rectal tumors. This chapter addresses the current role of various imaging modalities in colorectal tumor staging. This review contains 4 figures and 50 references. Key words: Preoperative imaging, Colorectal cancer, Magnetic resonance imaging, Diffusion weighted MRI, Computed tomography, Mesorectal fascia, TNM staging, Treatment stratification

Radiographic Staging of Colorectal Cancer

2019 ◽  
Author(s):  
Maurits P. Engbersen ◽  
Max J. Lahaye ◽  
Regina G.H. Beets-Tan
Keyword(s):  
Magnetic Resonance Imaging ◽  
Colorectal Cancer ◽  
Computed Tomography ◽  
Rectal Cancer ◽  
Magnetic Resonance ◽  
Tumor Staging ◽  
Tnm Staging ◽  
Preoperative Imaging ◽  
Resonance Imaging ◽  
Colon And Rectal Cancer

Imaging increasingly plays an important role in selecting the most optimal treatment for patients with colon and rectal cancer. While in colon cancer, computed tomography (CT) remains the modality of choice for local and distant staging, in patients with rectal cancer magnetic resonance imaging (MRI) is the main modality and mandatory for local staging. Endoluminal rectal ultrasound (ERUS) is the preferred staging method for superficial rectal tumors. This chapter addresses the current role of various imaging modalities in colorectal tumor staging. This review contains 4 figures and 50 references. Key words: Preoperative imaging, Colorectal cancer, Magnetic resonance imaging, Diffusion weighted MRI, Computed tomography, Mesorectal fascia, TNM staging, Treatment stratification

Assessment of Circumferential Resection Margins (CRM) clearance in Conventional open Versus Laparoscopic Cancer Rectum Resection

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Ibrahim H Bayan ◽  
Ahmed Abdelaziz ◽  
Tarek Youssef Ahmed ◽  
Mohamed Magdy
Keyword(s):  
Rectal Cancer ◽  
Laparoscopic Surgery ◽  
Abdominal Surgery ◽  
Open Surgery ◽  
Laparoscopic Group ◽  
Resection Margins ◽  
Laparoscopy Group ◽  
Surgery Group ◽  
Colon And Rectal Cancer ◽  
Significant Difference

Abstract Background Colon and rectal cancer represent the fourth commonest malignancy worldwide. Globally, colon and rectal cancer make up 9.4% and 10.1% in men and women of all cancers, respectively. Colon and rectal tumors are the third most common malignancy after breast and lung cancer, respectively. The main management of rectal cancer involves a multi-disciplinary team approach and an individually tailored treatment routine. Operative surgery remains the primary and definitive treatment for locally confined rectal adenocarcinoma and is the only historical and current treatment which allows for cure. Resection of the colon and rectal cancer can be done either by open surgical excision or laparoscopically. Aim of the work The objective is to compare the radicality of total mesorectal excision for rectal cancer in both open and laparoscopic surgery through the pathology report. Methods In this multicentric, prospective, comparative study, we included the pathologically established rectal cancer patients from 2 hospitals in Cairo, Egypt, Ain Shams University Hospitals and Maadi Military Hospital, Egypt between 2013 and 2016. The sample size was 40 patients divided into two groups; 20 patients for laparoscopic arm and 20 patients for the open trans-abdominal surgery. Inclusion criteria: histopathology confirmed rectal cancer, patients fit for operative resection, and with T1- T3 grades according to the preoperative evaluation. The exclusion criteria: Patients with T4 stage tumor, patients present as emergency cases and patients present with recurrence of the tumor and synchronous colonic tumors. Results The circumferential resection margins (CRM) of the mesorectum when examined pathologically after resection showed no difference between the two arms of the study with laparoscopic group specimens 3.18±1.16 mm mean, (SD) compared to 3.50±0.45 mm mean, (SD) in the open surgery group with no statistically significant difference. The longitudinal resection margins (LRM) was (5.50±1.98 mean, SD) in the laparoscopic group compared to (5.20±2.28 mean, SD) in the open conventional surgery group with no significant difference found between the two groups. Total operative time was significantly shorter in the trans-abdominal surgery group, while the hospital stay period was significantly shorter in the laparoscopy group. Laparoscopy group also showed significantly time before flatus passage, and the patients in the laparoscopy group started oral intake faster than open surgery group. Conclusion In our study, the radicality of the rectal cancer excision in both laparoscopic and traditional open surgery, showed non inferiority of the laparoscopic technique over open surgery Long-term clinical outcomes of overall survival and recurrence is the foremost parameters which should be taken in consideration for decision for laparoscopic surgery for rectal cancer. Additional follow-up results from the current trial are presently being developed, beside with records on other secondary end points, like cost effectiveness and quality of life.

Adjuvant and Neoadjuvant Management of Colorectal Cancer

2020 ◽  
Author(s):  
Christina E Bailey ◽  
Eduardo Vilar ◽  
Y. Nancy You
Keyword(s):  
Colorectal Cancer ◽  
Rectal Cancer ◽  
Neoadjuvant Therapy ◽  
Significant Proportion ◽  
Operative Management ◽  
The United States ◽  
Current Evidence ◽  
Recurrence Rates ◽  
Curative Intent ◽  
Colon And Rectal Cancer

Colorectal cancer (CRC) is the third most common and lethal cancer in men and women in the United States. At presentation, a significant proportion of patients with CRC are able to undergo resection with curative intent, but up to 50% of these patients will develop recurrent disease. Fortunately, recurrence rates for both colon and rectal cancer have improved with the introduction of multimodality therapies, which include chemotherapy, chemoradiation therapy, and radiation therapy. These therapies are adjuncts to surgery and can be administered before (i.e. neoadjuvant) or after (i.e. adjuvant) surgery. This review summarizes the current evidence for the use of adjuvant and neoadjuvant therapies in colon and rectal cancer. This review contains 2 figures, 7 tables, and 77 references. Keywords: Colon cancer, rectal cancer, neoadjuvant therapy, adjuvant therapy, total neoadjuvant therapy, induction chemotherapy in rectal cancer, chemoradiation, organ preservation, non-operative management

Correlation between the number of positive nodes, number of dissected nodes and survival of patiens with colorectal cancer

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 13585-13585
Author(s):  
J. C. Marin Marmolejo ◽  
C. R. Villegas Mejia ◽  
J. P. Cardona Arcila ◽  
E. Mulett Vasquez ◽  
M. Osorio Chica ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Rectal Cancer ◽  
Overall Survival ◽  
Medical Records ◽  
Tnm Classification ◽  
Prognostic Indicator ◽  
Absolute Number ◽  
Colon And Rectal Cancer ◽  
Nodal Dissection ◽  
The Difference

13585 Background: According to the TNM classification, the prognosis of patients suffering from colon and rectal cancer has been defined taking into account the number of nodes reported positively. Objective: This work is intending to establish a relation between the number of positive nodes and the number of dissected nodes, relating it with the overall survival. Methods: 5500 medical records of patients were reviewed. 771 out of these corresponded to gastrointestinal cancer (14%) from which 351(6.38%) corresponded to colorectal cancer. From this group, 291 patients (82.9%) underwent a surgery. A relation between the number of positive nodes and the number of dissected nodes was established and called proportion of positivity (positive nodes/ dissected nodes × 100) and this was in turn related to a five year overall survival. Two groups were analyzed: proportion of positivity > than 50% and proportion of positivity < than 50%. Results: A report of 209 patients showing nodes was obtained (59.5%), with a means of 10.4 (rank 0–31) of dissected nodes per patient and a means of positive nodes of 2.4 (rank 0–22). Comparing the two groups the statistic significance starts to be obvious from the 18 months and the difference between the two groups continues increasing until the five years. The survival to five years for the group with the proportion > than 50% was 39% (IC 95%:13.4–64.5) compared to the survival for the group with a proportion < than 50% that was 75.7% (IC 95%:67.6–83.7) p<0.05. Conclusions: The proposal shows that not only is the absolute number of positive dissected nodes as only prognostic indicator (TNM) but also that before nodes dissections with low number of them, it is possible to establish a reliable prognostic relationship by calculating the proportion of positivity. The above said does not consider that the nodal dissection can be less than recommended, on the contrary obtaining the biggest number of nodes will mean bigger equivalence of the proposal and a bigger possibility to detect positive nodes. No significant financial relationships to disclose.

Incidence of minimally invasive colorectal cancer (CRC) surgery in patients treated at NCCN institutions

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 6575-6575
Author(s):  
M. Weiser ◽  
D. Romanus ◽  
A. terVeer ◽  
A. Rajput ◽  
J. Skibber ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Minimally Invasive ◽  
Open Surgery ◽  
Early Stage ◽  
Oncologic Outcome ◽  
Stage I ◽  
Invasive Approach ◽  
Conversion To Open Surgery ◽  
The North ◽  
Minimally Invasive Surgical

6575 Background: In May 2004 the Clinical Outcomes of Surgical Therapy Study Group published the results of the North American randomized trial demonstrating that oncologic outcome is similar for laparoscopic assisted and open surgery for CRC. This and other studies have shown quicker recovery with laparoscopic CRC surgery including earlier resolution of postoperative ileus, less discomfort, and earlier discharge from the hospital. The extent to which surgeons have adopted the minimally invasive surgical (MIS) approach in CRC is unknown. Methods: Using the NCCN Colon/Rectal Cancer Outcomes Project Database, 715 patients were identified who underwent CRC resection in 2005–6. The distribution of lesions included right colon (39%), left colon (31%), and rectum (30%). The incidence of MIS for CRC and clinicopathologic features associated with this approach were analyzed by logistic regression; results are reported as odd ratio (OR) with 95% confidence intervals (CI), and significance defined at p<0.05 level. Results: A total of 167 (23%) patients underwent MIS colorectal surgery (laparoscopy in 98% and robotic in 2%). Conversion to open surgery was noted in 33 cases (20%). Surgery was performed in outside institutions in 21% of cases prior to patients presenting to NCCN institutions for further treatment. The MIS approach was more common in colon than rectal cancer (30% vs.12%, OR 2.96, CI 1.94–4.51, p<0.0001). Within the colon cancer cohort, right sided lesions were more likely to be approached with MIS techniques rather than left sided lesions (32% vs. 25%; OR 1.42, CI 1.96–2.21, p<0.0001). Stage I tumors were also more likely to be managed with the less invasive approach: Stage I-41%; II-20%; III-21%; IV-19% (Stage I vs. IV, OR=3.00, CI 1.74–5.16 p<0.0001). No differences in surgical approach were noted based on age, gender, race, Charlson comorbidity score, insurance type, or location of surgery (NCCN vs outside facility). Conclusion: The majority of CRC surgery for patients presenting to NCCN institutions is performed by open techniques. Right sided and early stage CRCs were more likely treated with MIS, possibly related to the less demanding nature of the procedure. The adoption of MIS is expected to rise as surgeons become trained in MIS techniques for CRC. No significant financial relationships to disclose.

Sign in / Sign up

Export Citation Format

Share Document