Our Summary

This research paper examines different surgical treatment methods for Lynch syndrome, a genetically inherited condition that increases the risk of colorectal cancer. The two surgical options considered are segmental colectomy, where a portion of the colon is removed, and extensive colectomy, where a larger section or the entire colon is removed. The researchers conducted a systematic review of existing studies to compare the risks of developing further cancer (metachronous colorectal cancer or MCC) and of patient mortality following both types of surgeries.

The results showed that patients who underwent segmental colectomy had a significantly higher risk of developing MCC (over 22%) compared to those who had an extensive colectomy (around 5%). However, there was no significant difference in patient mortality between the two types of surgeries. The researchers suggest that although the type of surgery doesn’t seem to affect the mortality rate, it does impact the likelihood of needing further surgery. Extensive colectomy could potentially reduce the need for additional surgeries and associated hospital stays and costs.

The authors recommend that these findings should be discussed with patients when deciding on a treatment plan, and that a personalized approach should be taken considering the patient’s age, overall health, and genetic makeup. They also call for larger and more comprehensive studies to better understand the effects of each surgical method on survival rates and genetic factors.

FAQs

  1. What are the two surgical treatment methods for Lynch syndrome discussed in the research paper?
  2. What is the difference in risk of developing further cancer (MCC) between segmental colectomy and extensive colectomy?
  3. Does the type of colectomy surgery affect the patient’s mortality rate according to the research paper?

Doctor’s Tip

One helpful tip a doctor might give a patient considering a colectomy is to carefully weigh the potential risks and benefits of both segmental and extensive colectomy. It is important to discuss the likelihood of developing further cancer (MCC) and the potential need for additional surgeries with your healthcare provider. Additionally, consider your individual health factors and genetic makeup when making a decision about which type of surgery is best for you. It may be beneficial to seek a second opinion or consult with a specialist in colorectal surgery to ensure you are making an informed decision.

Suitable For

Patients with Lynch syndrome, a family history of colorectal cancer, inflammatory bowel disease, severe diverticulitis, or other conditions that increase the risk of colorectal cancer may be recommended for colectomy. Additionally, patients with advanced colorectal cancer that cannot be treated with other methods may also be candidates for colectomy. Ultimately, the decision to undergo colectomy should be made in consultation with a healthcare provider based on individual risk factors and treatment goals.

Timeline

Before colectomy, a patient may experience symptoms such as abdominal pain, changes in bowel habits, blood in the stool, and weight loss. They may undergo various diagnostic tests such as colonoscopy, CT scans, and genetic testing to confirm the presence of Lynch syndrome and colorectal cancer. Once the decision is made to undergo surgery, the patient will undergo pre-operative preparations such as bowel prep and consultations with the surgical team.

After colectomy, the patient will experience a recovery period in the hospital, which may include pain management, monitoring for complications, and gradually reintroducing food and liquids. They will also need to adjust to changes in bowel function, potentially requiring dietary modifications and lifestyle changes. Follow-up appointments with the surgical team and genetic counselors will be necessary to monitor for complications, screen for other cancers, and discuss long-term management strategies.

Overall, colectomy is a major surgical procedure that can have a significant impact on a patient’s quality of life and long-term health outcomes. It is important for patients to work closely with their healthcare providers to understand the risks and benefits of surgery and to develop a personalized treatment plan that takes into account their individual needs and preferences.

What to Ask Your Doctor

  1. What are the potential risks and benefits of segmental colectomy versus extensive colectomy for my Lynch syndrome?
  2. How will each type of surgery affect my risk of developing metachronous colorectal cancer (MCC)?
  3. Are there any specific factors in my case that would make one type of surgery more suitable for me than the other?
  4. How will each type of surgery impact my quality of life and long-term outcomes?
  5. What is the likelihood of needing additional surgeries or treatments in the future based on the type of surgery I choose?
  6. Are there any alternative treatment options I should consider before deciding on surgery?
  7. How experienced is the surgical team in performing colectomies for Lynch syndrome patients?
  8. What post-operative care and follow-up will be necessary after the surgery?
  9. Are there any clinical trials or research studies related to colectomy for Lynch syndrome that I should be aware of?
  10. How will my genetic makeup and family history of Lynch syndrome influence the effectiveness of the chosen surgical method?

Reference

Authors: Malik SS, Lythgoe MP, McPhail M, Monahan KJ. Journal: Fam Cancer. 2018 Oct;17(4):557-564. doi: 10.1007/s10689-017-0062-2. PMID: 29189962