Malignant: Polyps and Cancer
Colon and rectal cancers are highly prevalent in the United States as well as worldwide. Surgery offers the opportunity for cure in many of these patients. Different minimally invasive surgery (MIS) platforms exist that afford numerous benefits to patients while offering similar oncologic outcomes to open surgery. These techniques can be laparoscopic, robotic, or a combination of the two. As surgeons continue to gain experience in these techniques, their adoption will likely continue to grow. It is important to understand the available minimally invasive techniques for the treatment of colon and rectal surgery and to understand the benefits each technique has to offer in order to guide the care of patients with colon and rectal cancer. Additionally, knowledge of what surgical options are available may help guide referrals of interested patients seeking specialty care to centers that specialize in laparoscopic and robotic surgery. This chapter summarizes the minimally invasive techniques commonly employed in the treatment of colon and rectal surgery, their benefits compared with open surgery, as well as the evidence supporting their use.
KeywordsColon cancer Rectal cancer Colon polyps Rectal polyps Laparoscopy Transanal
- 4.Benson AB 3rd, Venook AP, Cederquist L, Chan E, Chen YJ, Cooper HS, Deming D, Engstrom PF, Enzinger PC, Fichera A, Grem JL, Grothey A, Hochster HS, Hoffe S, Hunt S, Kamel A, Kirilcuk N, Krishnamurthi S, Messersmith WA, Mulcahy MF, Murphy JD, Nurkin S, Saltz L, Sharma S, Shibata D, Skibber JM, Sofocleous CT, Stoffel EM, Stotsky-Himelfarb E, Willett CG, Wu CS, Gregory KM, Deborah Freedman-Cass. Colon cancer, version 1.2017, NCCN clinical practice guidelines in oncology. J Natl Compr Canc Netw. 2017;15:370–98.CrossRefGoogle Scholar
- 5.Bertelsen CA, Neuenschwander AU, Jansen JE, Wilhelmsen M, Kirkegaard-Klitbo A, Tenma JR, Bols B, Ingeholm P, Rasmussen LA, Jepsen LV, Iversen ER, Kristensen B, Gogenur I, Danish Colorectal Cancer G. Disease-free survival after complete mesocolic excision compared with conventional colon cancer surgery: a retrospective, population-based study. Lancet Oncol. 2015;16:161–8.CrossRefGoogle Scholar
- 6.Biffi R, Luca F, Pozzi S, Cenciarelli S, Valvo M, Sonzogni A, Radice D, Ghezzi TL. Operative blood loss and use of blood products after full robotic and conventional low anterior resection with total mesorectal excision for treatment of rectal cancer. J Robot Surg. 2011;5:101–7.CrossRefGoogle Scholar
- 8.Bonjer HJ, Deijen CL, Abis GA, Cuesta MA, van der Pas MH, De Lange-De Klerk ES, Lacy AM, Bemelman WA, Andersson J, Angenete E, Rosenberg J, Fuerst A, Haglind E, COLOR II Study Group. A randomized trial of laparoscopic versus open surgery for rectal cancer. N Engl J Med. 2015a;372:1324–32.CrossRefGoogle Scholar
- 11.Clinical Outcomes of Surgical Therapy Study Group, Nelson H, Sargent DJ, Wieand HS, Fleshman J, Anvari M, Stryker SJ, Beart RW Jr, Hellinger M, Flanagan R Jr, Peters W, Ota D. A comparison of laparoscopically assisted and open colectomy for colon cancer. N Engl J Med. 2004;350:2050–9.CrossRefGoogle Scholar
- 12.Engstrom PF, Arnoletti JP, Benson AB 3rd, Chen YJ, Choti MA, Cooper HS, Covey A, Dilawari RA, Early DS, Enzinger PC, Fakih MG, Fleshman J Jr, Fuchs C, Grem JL, Kiel K, Knol JA, Leong LA, Lin E, Mulcahy MF, Rao S, Ryan DP, Saltz L, Shibata D, Skibber JM, Sofocleous C, Thomas J, Venook AP, Willett C, National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: rectal cancer. J Natl Compr Canc Netw. 2009;7:838–81.CrossRefGoogle Scholar
- 15.Guillou PJ, Quirke P, Thorpe H, Walker J, Jayne DG, Smith AM, Heath RM, Brown JM, MRC CLASICC Trial Group. Short-term endpoints of conventional versus laparoscopic-assisted surgery in patients with colorectal cancer (MRC CLASICC trial): multicentre, randomised controlled trial. Lancet. 2005;365:1718–26.CrossRefGoogle Scholar
- 17.Jayne D, Pigazzi A, Marshall H, Croft J, Corrigan N, Copeland J, Quirke P, West N, Rautio T, Thmoassen N, Tilney H, Gudgeon M, Bianchi PP, Edlin R, Hulm C, Brown J. Effect of robotic-assisted vs conventional laparoscopic surgery on risk of conversion to open laparotomy among patients undergoing resection for rectal cancer: the ROLARR randomized clinical trial. JAMA. 2017;318(16):1569–80.CrossRefGoogle Scholar
- 18.Kang SB, Park JW, Jeong SY, Nam BH, Choi HS, Kim DW, Lim SB, Lee TG, Kim DY, Kim JS, Chang HJ, Lee HS, Kim SY, Jung KH, Hong YS, Kim JH, Sohn DK, Kim DH, Oh JH. Open versus laparoscopic surgery for mid or low rectal cancer after neoadjuvant chemoradiotherapy (COREAN trial): short-term outcomes of an open-label randomised controlled trial. Lancet Oncol. 2010;11:637–45.CrossRefGoogle Scholar
- 23.Mutch MG. The ASCRS textbook of colon and rectal surgery. New York: Springer; 2016.Google Scholar
- 26.Veldkamp R, Kuhry E, Hop WC, Jeekel J, Kazemier G, Bonjer HJ, Haglind E, Pahlman L, Cuesta MA, Msika S, Morino M, Lacy AM, COlon Cancer Laparoscopic or Open Resection Study Group (COLOR). Laparoscopic surgery versus open surgery for colon cancer: short-term outcomes of a randomised trial. Lancet Oncol. 2005;6:477–84.CrossRefGoogle Scholar
- 28.Whiteford MH. The ASCRS textbook of colon and rectal surgery. New York: Springer; 2016.Google Scholar
- National Cancer Institute. Cancer stat facts: colon and rectum cancer [Online]. National Cancer Institute. Available: https://seer.cancer.gov/statfacts/html/colorect.html. Accessed.
- Prevention, C. F. D. C. A. Available: https://www.cdc.gov/cancer/colorectal/index.htm. Accessed.