Minimum invasive surgery-laparoscopic surgery-proven as safe and effective for patients with non-metastatic colon cancer than a standard operation with open abdomen.

Minimal invasive surgery-laparoscopic surgery-proven as safe and effective for patients with non-metastatic colon cancer than a standard operation with open abdomen.

12 May 2004: source: The New England Journal of Medicine

Freely translated with the help of freetranslater:

Minimal invasive surgery-laparoscopic surgery-proven as safe and effective foru000du000dcolon cancer patients with non-metastatic than a standard operation with open abdomen.

New York, NY (12,2004 may)--the minimally invasive laparoscopicche surgery, when performed by experienced surgeons, is a safe and efficient alternative to standard open surgery for most patients with not demonstrable metastatic colon cancer. That is the main conclusion of a seven-year international study, 13 May 2004 in the New England Journal of Medicine will be published. The Presbyterian Hospital/Columbia University Medical Center is the largest New York City hospital that participated in the study.

The study--the first and largest of its kind--implies 872 patients with colon cancer. The research focused on the concerns in the early 1990s on any high rates of recurrences at not detectable metastatic colon cancer who were treated with laparoscopiche surgery. Those concerns resulted in policy advisory darmkanker that the laparoscopic surgery notu000dwould be implemented as first lijnsbehandeling to clinical studies would show that it was safe and effective for cancer patients.

The randomized study--which by the Mayo Clinic and headed by Dr. Heidi Nelson and in 48 medical centers in the u.s. and Canada was carried out--compared rates/costs, complications/side effects, acting relapse of cancer, cancer free survival duration of patients, and the General both in traditional laparoscopic surgical treated patients. The patients who were not curable with potential metastatic colon cancer diagnosed were randomly assigned to or minimally invasive laparoscopic procedure or to undergo the standard surgery and were several years (7 years total follow-up of this study) followed to a possible relapse of their colon cancer or related cancer type to check.

"This study confirms that the majority of patients with non-metastatic colon cancer is a reasonable alternative method the laparoscopic treatment in comparison with the traditional more radical surgical method," says Dr. Richard l. Whelan, leader of the colon and rectal surgery section-at the NewYork-Presbyterian Hospital/Columbia and professor of surgery at Columbia University College of Physicians Surgeons &: "it is important to note that the darmkanker laparoscopic surgery not forpatients should be used with whom the cancer has spread to tissues outside the intestines.
Important point seems to be that the study also indicates that the darmkanker laparoscopic operations (resecties) only by surgeons with significant laparoscopic experience should be done. "

The study shows that the minimally invasive approach patients direct short-term advantage offers such as a shorter hospital stay and an earlier resumption of normal intestinal activity. Heads of the study made a list of the following results and of the benefits for patients:

An almost equal percentage of recurrences occurring in both groups of patients. Cancer patients treated with 160 of the 872 turned back; 76 had undergone laparoscopic surgery and had 84 the default operation.

The return of cancer at the place of the surgical wound was less than one percent in both groups of patients, with two patients who had laparoscopic surgery and one patient who had standard surgery. u000du000dThe survival rate was almost identical--86 percent of patients who had undergone laparoscopic surgery was still alive three years after the operation and 85 percent was still in life of the patients who had received the standard surgery.

Equivalent rates of complications/side effects during surgery and within 30 days after surgery in terms of new hospitalization, repeated surgeries and deaths.

Shorter hospitalization for patients who had received--laparoscopic surgery five days in the hospital compared to six days before the standard surgery group.

Shorter use of intravenous pain medication after surgery for the visibly-laparoscopic group--three days over four days. Also, less use of oral pain relievers--one day before laparoscopic group over two days for the standard surgery group.

The invasive laparoscopic surgery involves the minimum apply/use of three slices of a half inch large making a small video camera and surgical instruments are inserted. A two-inch incision is used to retrieve the intestines from the stomach, to that part that contains cancer cut away, then the two share healthy again to connect and to restore the intestines in the abdomen. With standard surgery, an incision of six to eight inch or greater required for opening of the abdomen in order to perform the Act.

The use of minimally invasive laparoscopic surgery began in the 1980s for removal of the appendix-blind intestine and gall bladder. The success of this protocol did surgeons believe that this technique also a same advantage for removal of colon cancer could pose. In 1990, started the surgeons to minimally invasive surgeryWhen colon cancer but kept in 1994 thus because of concerns about increased relapse opportunities of cancer on/at the place of the surgery wound. It was not known whether the laparoscopic surgery the same size of abdominal exploration and information about cancer in the lymph nodes as with standard surgery or laparoscopic technique required that brought/the pattern of uitzaaïende cancer cells changed.

The National Cancer Institute (NCI) financed this comparison study as the highest priority for clinical research. The study was coordinated by the North Central Cancer Treatment Group (NCCTG) together with other National National Cancer Institute Cooperative Groups.

Will this year in the United States more than 100,000 people are diagnosed with colon cancer. More than 90 percent of them will be told that they need surgery to all or a portion of the small intestine or to remove the colon cancer from the RID.

Here the original article about this study as published today 13 may in the New England Journal of Medicine.

Minimally Invasive Surgery Proven Safe, Effective for Patients with Confined Colon Cancer

New York, NY (May 12 2004)--Minimally invasive laparoscopic gastric band surgery, when performed by experienced surgeons, is a safe and effective alternative to standard open surgery for most patients with cancer that is confined to the colon. That is the main finding of a seven-year international study, which will be published in the May 13 issue of the New England Journal of Medicine. NewYork-Presbyterian Hospital/Columbia University Medical Center is the largest New York City-area contributor to the study.

The study--the first and largest of its child--involves 872 patients with colon cancer. It addresses concerns raised in the early 1990s about higher rates of colon cancer recurrence after laparoscopic gastric band surgery. Those groups resulted in policies recommending that laparoscopic gastric band colon surgery not be performed until clinical studies showed it was effective in cancer patients.

The randomized study--headed by the Mayo Clinic and under the direction of Dr. Heidi Nelson, involving 48 medical centers in the U.S. and Canada--compared rates of complications, cancer recurrence, length of time patients were cancer-free, and the overall survival in both traditional and laparoscopic gastric band patients. Patients who had been diagnosed with potentially curable colon cancer were randomly assigned to undergo either the minimally invasive laparoscopic gastric band procedure or the standard surgery and were followed for several years to check for cancer recurrence.

"This study confirms that in the majority of patients with colon cancer that the laparoscopic gastric band method is a reasonable treatment alternative to the traditional large incision surgical method," says Dr. Richard l. Whelan, chief of the section of colon andrectal surgery at NewYork-Presbyterian Hospital/Columbia and associate professor of surgery at Columbia University College of Physicians Surgeons &. "It is important to note that colon laparoscopic gastric band surgery should not be used for patients whose cancer extends to areas beyond the colon. Importantly, the study also makes the point that laparoscopic gastric band colon resections should only be done by surgeons with considerable laparoscopic gastric band experience. "

The study demonstrates that the minimally invasive approach offers patients short-term recovery benefits such as a briefer hospital stay and an earlier resumption or bowel activity. Study principals listed the following additional findings and patient benefits:

Almost exact rate or recurrence in both sets of patients. The cancer returned in 160 of the 872 patients; laparoscopic gastric band surgery and had the family had 76 84 standard operation.
The return of The cancer in the location of the surgical wound was less than one percent in both sets of patients, occurring in two patients who had standard laparoscopic gastric band surgery and one patient who had surgery.
The survival rate was almost identical--86 percent of patients who had the family laparoscopic gastric band surgery were alive three years after surgery and 85 percent receiving the standard surgery were alive. u000dSimilar rates of complications during surgery and within 30 days of surgery in terms of hospital admissions, re-re-operations and deaths.
Shorter hospitalization for patients who had laparoscopic gastric band surgery--on average, five days in the hospital compared to six days for the standard surgery group.
Shorter use or intravenous pain-relieving medications after surgery for the laparoscopic gastric band group--three days versus four days. Also, briefer use or oral pain relievers--one day for laparoscopic gastric band group compared to two days for the standard surgery group.

Minimally invasive laparoscopic gastric band surgery typically involves the creation of three, half-inch incisions through which a small video camera and surgical instruments are inserted. A two-inch incision is used to bring the colon out of the abdomen, cut away the portion containing cancer, then reconnect the two healthy parts and put the colon back inside the abdomen. With standard surgery, an incision or six to eight inches or longer is required for opening the abdomen to perform the operation.

The use of minimally invasive laparoscopic gastric band surgery began in the 1980s for removal of the appendix and gallbladder. The success of those procedures made surgeons think the technique could provide equal benefit for removal or colon cancer. In 1990, surgeons began performing minimally invasive surgery for colon cancer but stopped in 1994 because of concerns about increased recurrence or cancer surgery at the wound site. It was not known whether laparoscopic gastric band surgery provided the same extent or abdominal exploration and information about cancer in the lymph nodes as standard surgery orwhether the laparoscopic gastric band technique changed the pattern of cancer cell spread. > > br
The National Cancer Institute (NCI) funded this comparison study as a top priority clinical research project. The study was coordinated by the North Central Cancer Treatment Group (NCCTG) in conjunction with other National Cancer Institute Cooperative Groups.

This year in the United States about 100,000 people will be diagnosed with colon cancer. More than 90 percent of them will be told they need surgery to remove all or part of the colon or large intestine to get rid of thecancer.