Minimally Invasive Colon Cancer Surgery Found Effective

A study by an international team of surgeons has determined that minimally invasive surgery is as safe and effective as standard open surgery for most patients with cancer confined to the colon. The results were reported in the May 13, 2004, issue of The New England Journal of Medicine.

In addition to the cosmetic benefits of having a smaller incision, patients who received the minimally invasive procedure, called laparoscopically assisted colectomy, required one less day in the hospital, one less day on intravenous pain killers, and one less day on oral pain killers. Typically, surgeons open the abdomen with a six-to-eight-inch incision and then cut away the portion of the colon containing cancer. During laparoscopically assisted colectomy, the same procedure is performed through three one-half-inch incisions and one two-inch incision.

During their investigation, the team of surgeons put a moratorium on laparoscopically assisted colectomy performed outside the scope of their study. They also enforced qualifications requirements for the 66 surgeons who participated in the study, and established standardized operating procedures. The results showed that cancer returned to the colon or to the location of the surgical wound at almost the exact same rate in both groups of patients. The survival rates, overall survival, and rates of complications also were nearly identical.

The research team has submitted a position statement to the American Society of Colon and Rectal Surgeons proposing that credentials for performing laparoscopically assisted colectomies should only be given to surgeons who meet specific qualifications and strictly adhere to standard operating procedures. "Our plea is that the surgical community apply the same standard operating techniques known to safely remove cancer when they perform this less-invasive procedure,” said James W. Fleshman Jr., M.D., professor of surgery at Washington University School of Medicine in St. Louis (MO, USA) and a key contributor to the study, led by the Mayo Clinic (Rochester, MN, USA).




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