Role of laparoscopy in the initial multimodality management of patients with near-obstructing rectal cancer Journal Article
| Authors: | Koea, J. B.; Guillem, J. G.; Conlon, K. C.; Minsky, B.; Saltz, L.; Cohen, A. |
| Article Title: | Role of laparoscopy in the initial multimodality management of patients with near-obstructing rectal cancer |
| Abstract: | The purpose of this study was to investigate the role of diagnostic laparoscopy in the multimodality management of locally advanced, near-obstructing rectal cancer. Fourteen patients with near-obstructing adenocarcinoma of the rectum (8 men and 6 women; mean age 49 years) underwent staging laparoscopy and formation of a sigmoid loop colostomy (n = 7), transverse colostomy (n = 4), or ileostomy (n = 3). The mean operative time was 78 minutes (range 67 to 94 minutes). All patients began a regular diet on post-operative day 1 and the median time to discharge was 4 days (range 2 to 8 days). Four patients were found to have diffuse peritoneal carcinomatosis not defined on preoperative CT scan. These patients died of disease within 6 months. Ten patients with advanced, localized pelvic disease began preoperative combinedmodality treatment (5040 cGy external-beam radiation therapy in conjunction with 5-fluorouracil/leucovorin) between 8 and 13 days (median 9 days) following laparoscopy, and all underwent successful resection with clear margins in a median time of 12 weeks following laparoscopy. In the initial management of patients with near-obstructing advanced rectal cancer, laparoscopy can be both therapeutic and diagnostic by clarifying the site of the primary tumor, identifying patients with unsuspected peritoneal disease, and facilitating the formation of a defunctioning stoma with minimal morbidity. This leads to the early commencement of preoperative combined-modality treatment and does not compromise the prospects of subsequent tumor resection. |
| Keywords: | middle aged; multimodality cancer therapy; combined modality therapy; cancer staging; neoplasm staging; laparoscopy; adenocarcinoma; metastasis; peritoneal neoplasms; time; time factors; ileostomy; rectal neoplasms; rectum tumor; peritoneum tumor; rectal cancer; colostomy; multimodality therapy; humans; human; male; female; article |
| Journal Title: | Journal of Gastrointestinal Surgery |
| Volume: | 4 |
| Issue: | 1 |
| ISSN: | 1091-255X |
| Publisher: | Springer |
| Date Published: | 2000-02-01 |
| Start Page: | 105 |
| End Page: | 108 |
| Language: | English |
| PUBMED: | 10631370 |
| PROVIDER: | scopus |
| DOI: | 10.1016/S1091-255X(00)80040-2 |
| DOI/URL: | |
| Notes: | Presented at the 40th Annual Meeting of The Society for Surgery of the Alimentary Tract, Orlando, FL, 1999 May 16-19 -- Export Date: 18 November 2015 -- Source: Scopus |
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