Our Summary

The research paper is about the use of laparoscopic surgery (a minimally invasive surgical technique) in urgent or emergency cases of colorectal cancer treatment in England’s National Health Service. The study looked at patient data from April 2010 to March 2016. The use of laparoscopy in these emergency situations doubled from 15.1% in 2010 to 30.2% in 2016. The study found that the use of laparoscopy was less common in patients who were in poorer physical condition and those with more advanced stages of cancer. Age, socioeconomic status, the hospital’s volume of patients, and whether the hospital had a dedicated colorectal emergency service did not affect the use of laparoscopy.

The study found that patients who had laparoscopic surgery had shorter hospital stays (8 days compared to 12 days for traditional surgery) and a lower risk of death within 90 days of surgery (8.1% compared to 13.0% for traditional surgery). There was no difference in the number of patients who had to be readmitted to the hospital or needed additional surgery.

In simple terms, the study concludes that using laparoscopic surgery for emergency colorectal cancer treatment is associated with patients getting out of the hospital sooner and having a lower risk of dying after surgery.

FAQs

  1. What is the rate of laparoscopic surgery usage for emergency colorectal cancer treatment in England’s National Health Service between 2010 and 2016?
  2. Does the physical condition or stage of cancer affect the use of laparoscopic surgery for emergency colorectal cancer treatment?
  3. What are the benefits of using laparoscopic surgery for emergency colorectal cancer treatment according to the study?

Doctor’s Tip

A helpful tip a doctor might tell a patient about laparoscopic colectomy is to expect a quicker recovery time and potentially lower risk of complications compared to traditional surgery. It is important to follow post-operative care instructions and attend follow-up appointments to ensure a successful recovery.

Suitable For

Typically, patients who are in better physical condition and have less advanced stages of colorectal cancer are recommended for laparoscopic colectomy. This minimally invasive surgical technique is associated with shorter hospital stays and lower risk of death within 90 days of surgery compared to traditional surgery. Factors such as age, socioeconomic status, hospital volume, and the presence of a dedicated colorectal emergency service did not affect the use of laparoscopy in emergency cases of colorectal cancer treatment.

Timeline

Timeline of patient experience before and after laparoscopic colectomy:

Before Surgery:

  • Patient is diagnosed with colorectal cancer.
  • Patient undergoes preoperative evaluations and tests to determine the stage of cancer and overall health.
  • Patient is informed about the surgical options, including laparoscopic colectomy.
  • Patient may need to undergo chemotherapy or radiation therapy before surgery to shrink the tumor.
  • Surgery date is scheduled and patient is instructed on preoperative preparations, such as fasting and medications.

During Surgery:

  • Laparoscopic colectomy is performed, where small incisions are made in the abdomen and a camera and instruments are inserted to remove the affected part of the colon.
  • Surgery typically lasts 2-4 hours, depending on the complexity of the case.
  • Patient is closely monitored by the surgical team for any complications during the procedure.

After Surgery:

  • Patient is taken to the recovery room and monitored for any signs of complications.
  • Patient may experience pain, bloating, and discomfort in the abdomen postoperatively.
  • Patient is encouraged to start moving around and walking to prevent blood clots and aid in recovery.
  • Patient is gradually introduced to a liquid diet and then advanced to solid foods as tolerated.
  • Patient is discharged from the hospital once they are able to eat, walk, and manage pain effectively.
  • Patient is instructed on postoperative care, including wound care, diet modifications, and activity restrictions.
  • Patient follows up with their surgeon for postoperative appointments to monitor recovery and discuss further treatment options.

Overall, the patient’s journey before and after laparoscopic colectomy involves thorough evaluation, surgery, and postoperative care to ensure a successful outcome and recovery from colorectal cancer treatment.

What to Ask Your Doctor

Some questions a patient should ask their doctor about laparoscopic colectomy for colorectal cancer treatment include:

  1. What are the potential benefits of laparoscopic colectomy compared to traditional surgery for my specific situation?
  2. What are the potential risks or complications associated with laparoscopic colectomy?
  3. How experienced are you and your surgical team in performing laparoscopic colectomy procedures?
  4. What is the expected recovery time and post-operative care following laparoscopic colectomy?
  5. Will I need any additional treatments or follow-up care after the surgery?
  6. How will my pain be managed after the surgery?
  7. What are the chances of needing additional surgery or experiencing complications after laparoscopic colectomy?
  8. Are there any specific factors about my health or condition that may affect the success of laparoscopic colectomy?
  9. How will my quality of life be impacted after laparoscopic colectomy compared to traditional surgery?
  10. Are there any alternative treatment options that I should consider before deciding on laparoscopic colectomy?

Reference

Authors: Vallance AE, Keller DS, Hill J, Braun M, Kuryba A, van der Meulen J, Walker K, Chand M. Journal: Ann Surg. 2019 Jul;270(1):172-179. doi: 10.1097/SLA.0000000000002752. PMID: 29621034