A less invasive surgical procedure appears to be effective in the treatment of colon cancer, according to a recent clinical trial published in the journal Surgical Endoscopy.

The colon and rectum are parts of the body’s digestive system and together form a long muscular tube called the large intestine. Treatment options depend on the stage, or extent of spread of cancer and may consist of chemotherapy, radiation, surgery and/or biological therapy (utilizing the body’s immune system to fight cancer). Colorectal cancer is defined as stage III when cancer has penetrated the wall of the colon into the abdominal cavity and invaded any of the local lymph nodes but cannot be detected in other locations in the body.

Colorectal cancer is one of the most common cancers in the world. The outcome of patients with this disease is steadily improving, mainly due to earlier detection methods and routine screening procedures. Currently, the only curative option for patients with this disease involves the surgical removal of the cancer. Patients with stage III colon cancer often require extensive surgery for the complete removal of their cancer. A hemicolectomy is currently the standard surgical procedure used to remove the cancer. A hemicolectomy is an invasive surgery which requires surgeons to create a large opening in the abdomen in order to reach the cancer. This extensive surgery can cause serious side effects including infections, severe pain and prolonged convalescence. These complications may increase mortality, prolong hospital stays, and significantly increase medical costs. As a result, surgeons have worked to develop less invasive surgical techniques for performing a hemicolectomy.

Recent advances in minimally invasive technology have allowed complex procedures to be performed with the aid of a video camera. A laparoscopic procedure has recently been shown to be effective for performing a hemicolectomy, while decreasing the side effects caused by extensive surgery. With this procedure, a few one-centimeter incisions are made in the patient’s abdomen. Then, a very small tube that holds a video camera can be inserted through the incisions, creating a live picture of the inside of the patient’s body. This picture is continually displayed on a television screen so that physicians can perform the entire surgery by watching the screen. Before the section of the colon containing the cancer is removed from the body, the incision through which it will be removed is enlarged to allow its passage with minimal contact.

In a recent clinical study, researchers from Texas evaluated the effectiveness of utilizing a laparascopic approach for hemicolectomies. The physicians involved in this study performed laparoscopic hemicolectomies on 50 patients with stage III colorectal cancer. Three years following surgery over 60% of patients had not died from cancer. Five years following surgery, nearly half of the patients were still alive. Importantly, these patients experienced significantly fewer infections and shortened hospital stays.

These results suggest that laparoscopic hemicolectomies produce comparable survival outcomes when compared with standard surgery, while decreasing surgery-related complications in patients with colorectal cancer. Patients with colorectal cancer may wish to speak with their physician about the risks and benefits of this surgical option or about the participation in a clinical trial further evaluating this procedure. Two sources of information on ongoing clinical trials that can be discussed with a doctor include comprehensive, easy-to-use clinical trials listing services provided by the National Cancer Institute (cancer.gov) and eCancerTrials.com. eCancerTrials.com also provides personalized clinical trial searches on behalf of patients. (Surgical Endoscopy, Vol 14, No 7, pp 612-616, 2000)

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