Patients with rectal cancer currently have no choice but to undergo extensive open surgery. An international study has found that laproscopy, which is equally effective and much less invasive, should be adopted both in Sweden and abroad.
Rectal cancer is the third most common form of the disease among both women and men in developed countries. The only effective treatment offered by current clinical practice is open surgery, sometimes combined with radiotherapy or chemotherapy. The extensive procedure involves a long postoperative recovery period.
Laproscopy less painful
A large international project has shown that patients stand to benefit by replacement of the traditional approach with laproscopy.
The project, which was conducted as a collaborative effort among 30 hospitals (of which Sahlgrenska University Hospital/East contributed the most patients) in eight countries, had previously shown that laproscopy is less painful than open surgery, reduces the risk of wound infections, and ensures faster recovery of bowel function and return to a normal diet (as opposed to intravenous drip).
Safe long-term option
A follow-up study among 1,044 patients has now found that the procedure is a safe long-term option as well—patients do not run a greater risk of relapse and they enjoy the same survival rates as those who receive traditional surgery.
Laproscopy is already in use for colon cancer and other conditions. But it had not been assessed previously for rectal cancer.
“The study shows that laproscopy offers both short-term benefits, enabling a speedier return to normal life, and equal long-term safety,” says Professor Eva Haglind, researcher at Sahlgrenska Academy, consulting surgeon at Sahlgrenska University Hospital/East and member of the international steering committee for the project. “Our conclusion is that the procedure should be adopted for rectal cancer as well. Swedish surgeons who treat the disease need training in laproscopy to catch up with the concerted efforts that are already under way among their colleagues in Denmark, the UK and other countries.”
“A Randomized Trial of Laproscopic versus Open Surgery for Rectal Cancer” will appear in the 2 March issue of the New England Journal of Medicine.
The international study was directed from Free University in Amsterdam.
FACTS ABOUT RECTAL CANCER
Approximately 1,800 Swedes are diagnosed with rectal cancer every year. The five-year survival rate is in the neighborhood of 60%, rising to 80% among those who are assessed at an early stage and undergo surgery. Hereditary factors appear to be the cause in a minority of cases. Research has also established that a sedentary lifestyle increases the risk of developing the disease.
