Our Summary

This study compared two surgical methods for treating rectal cancer: total mesorectal excision (TME) and TME combined with lateral lymph node dissection (LLND). The results showed that patients who underwent both TME and LLND had more complications than those who only had TME. However, the two groups did not differ significantly in terms of overall survival, recurrence of the disease, and urinary and sexual dysfunction. Therefore, while the combination of TME and LLND might cause more complications, more research is needed to confirm these findings.

FAQs

  1. What are the two surgical methods for treating rectal cancer discussed in this study?
  2. Did the study find any significant differences in overall survival or disease recurrence between the two treatment groups?
  3. What further research is suggested based on the findings of this study?

Doctor’s Tip

In order to have a successful recovery after a proctectomy, it is important to follow your doctor’s instructions for post-operative care. This may include taking pain medication as prescribed, doing gentle exercises to promote healing, eating a healthy diet rich in fiber to prevent constipation, and attending follow-up appointments to monitor your progress. It is also important to communicate any concerns or changes in symptoms to your doctor promptly.

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
  • Large or advanced tumors that cannot be removed through less invasive procedures
  • Inflammatory bowel disease (such as ulcerative colitis or Crohn’s disease) that cannot be managed with medication or other treatments
  • Severe complications such as fistulas, abscesses, or strictures in the rectum
  • Familial adenomatous polyposis (FAP) or other genetic conditions that increase the risk of developing rectal cancer

Overall, the decision to recommend proctectomy is based on the individual patient’s specific condition and needs, and should be made in consultation with a multidisciplinary team of healthcare providers.

Timeline

Before proctectomy:

  1. Patient is diagnosed with rectal cancer through imaging tests, biopsies, and physical exams.
  2. Patient undergoes preoperative evaluations such as blood tests, chest X-rays, and possibly a colonoscopy to assess the extent of the cancer.
  3. Patient may undergo neoadjuvant therapy such as chemotherapy and radiation to shrink the tumor before surgery.
  4. Patient meets with a surgical team to discuss the proctectomy procedure, potential risks, and postoperative care.

After proctectomy:

  1. Patient undergoes surgery to remove the rectum and surrounding tissues.
  2. Patient may stay in the hospital for a few days to recover and receive pain management.
  3. Patient will gradually resume eating solid foods and start walking to aid in recovery.
  4. Patient may experience temporary or permanent changes in bowel function, such as frequent bowel movements or the need for a colostomy bag.
  5. Patient will follow up with their surgical team for monitoring and possible additional treatments such as chemotherapy or radiation.
  6. Patient will undergo regular screenings and follow-ups to monitor for any signs of recurrence or complications.

What to Ask Your Doctor

  1. What are the risks and benefits of undergoing a proctectomy?
  2. How will my quality of life be affected after the surgery?
  3. What is the recovery process like and how long does it typically take?
  4. Will I need a colostomy or ileostomy after the surgery?
  5. How often will I need follow-up appointments and monitoring after the surgery?
  6. What is the success rate of this procedure for treating my specific condition?
  7. Are there any alternative treatments or surgical methods available for my condition?
  8. What are the potential long-term side effects or complications of the surgery?
  9. How experienced are you in performing proctectomies and what is your success rate?
  10. Are there any lifestyle changes or dietary restrictions I should follow after the surgery?

Reference

Authors: Wang X, Qiu A, Liu X, Shi Y. Journal: Int J Colorectal Dis. 2020 Jun;35(6):997-1006. doi: 10.1007/s00384-020-03610-1. Epub 2020 May 1. PMID: 32356120