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Colon Cancer Surgery Takes A New Turn

Originally published Jun 2008

Nearly 100,000 Americans are diagnosed with colon cancer each year. Patients with early colon cancer may benefit from minimally invasive colon cancer surgery rather than traditional open surgery.

A recent international study, which included two surgeons at Siteman Cancer Center, found that minimally invasive colon cancer surgery is as safe and effective as standard open surgery for most patients with cancer confined to the colon. This intricate procedure, called laparoscopic colectomy, requires smaller incisions, and results in a hospital stay two days shorter than traditional open surgery, and an at-home recovery time of about two weeks versus six weeks for traditional open surgery, according to James Fleshman Jr., MD, a chief of colorectal surgery at Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine.

In open colon cancer surgery, surgeons open the abdomen with a six- to eight-inch incision and then cut away the portion of the colon with cancer. Using minimally invasive techniques, the procedure is performed with half-inch to two-inch incisions.

But not everyone is adequately trained to remove colon cancer laparoscopically. The procedure is only safe and effective if stringent surgical standards for removing cancer are followed to avoid the risk of spreading the cancer.

As a result of the study, the American Society of Colon and Rectal Surgeons is developing stricter credentials for performing laparoscopic colectomies. Credentials may only be given to surgeons who meet specific qualifications and strictly adhere to standard operating procedures.

"A laparoscopic colectomy is the hardest laparoscopic procedure done today," Dr. Fleshman explains. "It requires moving around several parts of the abdomen and encountering lots of critical structures to get to the colon."

Dr. Fleshman has performed more than 700 laparoscopic colectomies since 1991. For those facing colon cancer, he recommends choosing a surgeon who concentrates on dealing with colorectal disease and asking how many colorectal procedures the surgeon does a year.

"A colorectal surgeon has specialized training beyond general surgery," Dr. Fleshman says. "They are specifically taught to make wide resections during minimally invasive colon cancer surgery so the local recurrence of cancer is almost zero. Specialized training has changed the way colorectal disease is treated and has improved outcomes."

Take a free online colon and rectal cancer risk assessment.

For a referral to a Siteman Cancer Center colorectal surgeon at Barnes-Jewish Hospital or for free Colorectal Cancer Awareness Kit call 314-TOP-DOCS (314-867-3627) or toll-free 866-867-3627.


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