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Minimally Invasive Surgery Shown Safe, Effective for Rectal Cancer NEW YORK -- November 11, 2009 -- In a prospective study of patients who underwent straightforward or hand-assisted laparoscopic surgery for rectal cancer, the minimally invasive approach can be as effective as traditional open surgery in treating rectal cancers. Rectal surgery, according to Jeffrey Milsom, MD, Colon and Rectal Surgery, NewYork-Presbyterian/Weill Cornell, New York, New York, is inherently more challenging than colon surgery. For one, the pelvic cavity of the body where the rectum lies, is a narrow space, making rectal tumours difficult to access. Surgical success depends not only on the complete removal of the cancerous tumour and repair of the rectum, but also on restoring continence. For these reasons, rectal cancer has been a difficult arena to apply advances in minimally invasive surgery. Delaying matters further, initial reports on the use of laparoscopic surgery in patients with rectal cancer described a higher incidence of cancer-positive cells at the edges of removed tumours compared with open surgery, said Dr. Milson. Early data suggested that as a result, more patients could experience a local recurrence of their rectal cancer after laparoscopic surgery than open surgery. However, the current study refutes these initial findings. Between January 1999 and December 2006, 3 colon and rectal surgeons at NewYork-Presbyterian/Weill Cornell treated 103 patients with mid or low rectal cancer using total mesorectal excision (TME), performed via laparoscopic-assisted (LAP) or hand-assisted laparoscopic surgery (HALS). To gather the relevant data and analyse outcomes, Dr. Milsom and his team relied on inpatient and outpatient medical records, telephone interviews with patients, and standard actuarial survival calculations. Patients received regular follow-up for 5 years. More than 90% of the patients were able to undergo laparoscopic surgery successfully and more than 95% emerged with an intact and functioning rectum and recovered rapidly. None had cancer-positive tumour margins. After 5 years, overall survival has remained high at 91% with more than 73% of patients completely free from disease. SOURCE: NewYork-Presbyterian Hospital/Weill Cornell Medical Center E-mail this page to a friend or colleague! To print, use this version