Our Summary

This research paper investigates whether the type of surgery for rectal cancer affects the chance of survival if complications occur. Two types of surgery were compared - traditional “open” surgery and a technique called laparoscopy, which is less invasive and involves inserting a small camera and instruments into the body through small cuts. The researchers analyzed data from 44,536 patients who had surgery for rectal cancer between 2012 and 2016. They found that those who had open surgery were more likely to have serious complications, die within 90 days of surgery, and die if complications occurred, compared to those who had laparoscopy. The researchers took into account factors such as age, health status, whether chemotherapy was used before surgery, and where the tumor was located. They concluded that open surgery was a risk factor for not surviving if complications occurred.

FAQs

  1. What types of surgery for rectal cancer were compared in this research?
  2. Does the type of surgery for rectal cancer affect the chance of survival if complications occur?
  3. According to the research, which surgery type resulted in more serious complications and higher mortality rates?

Doctor’s Tip

A doctor may advise a patient undergoing a proctectomy to consider laparoscopic surgery as it may reduce the risk of serious complications and improve chances of survival compared to traditional open surgery. It’s important to discuss the options with your surgeon and weigh the potential benefits and risks of each approach. Additionally, following post-operative care instructions and attending follow-up appointments are essential for a successful recovery.

Suitable For

Patients who are typically recommended proctectomy include those with rectal cancer that has not responded to other treatments such as chemotherapy or radiation therapy, those with advanced or aggressive tumors, those with a family history of colorectal cancer, and those with certain genetic conditions that increase the risk of developing colorectal cancer. Additionally, patients who have recurrent or persistent symptoms such as bleeding, pain, or bowel obstruction may also be recommended proctectomy.

Timeline

Before proctectomy:

  1. Patient is diagnosed with rectal cancer through imaging tests and biopsies.
  2. Patient undergoes pre-operative evaluations and consultations with healthcare providers to determine the best treatment plan.
  3. Patient may undergo chemotherapy or radiation therapy to shrink the tumor before surgery.
  4. Patient may be placed on a special diet or bowel preparation regimen to prepare for surgery.
  5. Patient receives instructions on how to prepare for surgery and what to expect during the recovery process.

After proctectomy:

  1. Patient undergoes the surgical removal of the rectum and part of the colon.
  2. Patient may stay in the hospital for a few days to recover and be monitored for any complications.
  3. Patient may experience pain, fatigue, and changes in bowel function after surgery.
  4. Patient may need to follow a special diet and take medications to manage pain and prevent infection.
  5. Patient will have follow-up appointments with healthcare providers to monitor recovery, assess for any complications, and discuss further treatment options such as chemotherapy or radiation therapy.
  6. Patient may undergo physical therapy or counseling to help with recovery and adjustment to life after surgery.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with a proctectomy?
  2. How will the surgery be performed (open surgery or laparoscopy) and what are the differences between the two techniques?
  3. What is the success rate of the surgery for my specific condition?
  4. How long is the recovery period and what can I expect during the recovery process?
  5. Will I need any additional treatments or therapies after the surgery?
  6. What are the long-term effects of undergoing a proctectomy?
  7. How often will I need follow-up appointments after the surgery?
  8. Are there any lifestyle changes or precautions I should take after the surgery?
  9. What support resources are available for me during and after the surgery?
  10. Are there any alternative treatment options available for my condition?

Reference

Authors: El Amrani M, Clement G, Lenne X, Turpin A, Valibouze C, Rogosnitzky M, Theis D, Pruvot FR, Zerbib P. Journal: Surg Endosc. 2022 Jan;36(1):435-445. doi: 10.1007/s00464-021-08303-6. Epub 2021 Apr 19. PMID: 33871717