Our Summary

This research study examined the effectiveness of different surgical methods used for rectal cancer. The three methods studied were open surgery, laparoscopy (a less invasive surgery using small incisions), and robotic surgery. Researchers used data from the American College of Surgeons National Surgical Quality Improvement Program to compare these methods.

The study found that out of the 578 patients studied, about 36% had open surgery, about 37% had laparoscopic surgery, and about 27% had robotic surgery. They found that converting to open surgery was more common for those originally undergoing laparoscopic surgery compared to robotic surgery.

However, the study found that there was no significant difference in the rate of positive circumferential resection margin (a measure of how successful the surgery was in removing the cancer) among the three methods. This suggests that all three methods are similarly effective in treating rectal cancer.

In simpler terms, the study concludes that less invasive surgical methods (like laparoscopy and robotic surgery) are not worse than open surgery when it comes to treating rectal cancer.

FAQs

  1. What surgical methods were examined in this research study for rectal cancer?
  2. Was there a significant difference in the effectiveness of open surgery, laparoscopy, and robotic surgery in treating rectal cancer?
  3. What does the research suggest about the effectiveness of less invasive surgical methods in comparison to open surgery for rectal cancer treatment?

Doctor’s Tip

A doctor might tell a patient that less invasive surgical methods such as laparoscopy or robotic surgery are just as effective as open surgery for treating rectal cancer. They may also recommend discussing the best surgical approach for their specific case with their healthcare team.

Suitable For

Patients who are typically recommended for proctectomy include those with rectal cancer that has not responded to other treatments, such as chemotherapy or radiation therapy. Additionally, patients with inflammatory bowel disease, such as ulcerative colitis or Crohn’s disease, may also be recommended for proctectomy if they have severe symptoms or complications. Patients with large polyps, rectal prolapse, or other conditions affecting the rectum may also be candidates for proctectomy. Ultimately, the decision to undergo proctectomy will depend on the individual patient’s specific condition and needs, and should be made in consultation with a healthcare provider.

Timeline

Before a proctectomy:

  1. Patient is diagnosed with rectal cancer and discusses treatment options with their healthcare provider.
  2. Patient undergoes preoperative testing and preparation for surgery.
  3. Patient may undergo chemotherapy and/or radiation therapy to shrink the tumor before surgery.
  4. Patient discusses the surgical approach with their surgeon and decides on open surgery, laparoscopic surgery, or robotic surgery.
  5. Patient undergoes the proctectomy procedure.

After a proctectomy:

  1. Patient is monitored closely in the hospital for complications and recovery.
  2. Patient may experience pain, discomfort, and temporary changes in bowel function.
  3. Patient receives postoperative care, including pain management and wound care.
  4. Patient may need a temporary colostomy or ileostomy to allow the bowel to heal.
  5. Patient undergoes follow-up appointments and monitoring to ensure the cancer has been successfully treated.
  6. Patient may require additional treatments, such as chemotherapy or radiation therapy, depending on the stage and aggressiveness of the cancer.
  7. Patient gradually resumes normal activities and lifestyle, with ongoing surveillance for recurrence of the cancer.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with a proctectomy?

  2. How long is the recovery period after a proctectomy and what can I expect during this time?

  3. Will I need any additional treatments, such as chemotherapy or radiation therapy, after the proctectomy?

  4. How experienced are you in performing proctectomy procedures, and what is your success rate?

  5. Can you explain the differences between open surgery, laparoscopic surgery, and robotic surgery for a proctectomy?

  6. What factors determine whether I am a candidate for laparoscopic or robotic surgery instead of open surgery?

  7. How will my quality of life be impacted after a proctectomy, and are there any long-term effects I should be aware of?

  8. Will I need to make any lifestyle changes or follow a special diet after the proctectomy?

  9. How often will I need follow-up appointments after the proctectomy, and what will these appointments involve?

  10. Are there any support groups or resources available to help me cope with the emotional and physical challenges of undergoing a proctectomy?

Reference

Authors: Garfinkle R, Abou-Khalil M, Bhatnagar S, Wong-Chong N, Azoulay L, Morin N, Vasilevsky CA, Boutros M. Journal: J Gastrointest Surg. 2019 Feb;23(2):348-356. doi: 10.1007/s11605-018-3974-8. Epub 2018 Sep 27. PMID: 30264386