Laparoscopic or open surgery for colon cancer

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nickr
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Laparoscopic or open surgery for colon cancer

Postby nickr » Mon May 16, 2016 10:39 pm

Just wondering if one should chose laparoscopic over open surgery if option is available. I understand the main benefit is quicker healing being less invasive, but am concerned with higher recurrence rates at the ports. Also read that it depends on the expertise of the surgeon. Like to hear results of those who chose laparoscopic and whether they agree it was the right choice for them. Thank you.
Last edited by nickr on Thu May 19, 2016 10:51 pm, edited 1 time in total.

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wwroam
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Re: Laporascopic or open surgery for colon cancer

Postby wwroam » Mon May 16, 2016 11:18 pm

I wasn't given the choice. It was open chest.
It was only long after I'd had my surgery that I even discovered that laparoscopic surgery existed. When I questioned my surgeon on a follow up visit he advised that will not perform lap. surgery. In an earlier "life" he had been Director of Colorectal Surgery at a major teaching public hospital in town so it wasn't as if he was incapable of performing that surgery. I didn't press the point.
I had a 7 day hospital admission and started to put in an appearance at my office 2 days later. Today I can barely see the scar.
Stage 3a DX 25/06/07
Folfox complete 30/01/08
7 years NED
Port scheduled for removal 8/02/10 Gone.
PSA .54 No prostate problems
Diagnosed Type 2 Diabetic
SO diagnosed CC Stage IV Liver Mets 23/03/15

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ANDRETEXAS
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Re: Laporascopic or open surgery for colon cancer

Postby ANDRETEXAS » Tue May 17, 2016 1:17 am

All I can say is that my colorectal surgeon said laparoscopic would be his preference for me. So I agreed. I can't say that one is better than the other. I guess it depends on where the cancer is located, its nature and the ability to do it laparoscopically.
2014
2/10 - Colon resect
2/13 - DX- Stage IIIb
6 of 18 lymph nodes cancerous
3/7 - Port placed
3/11 - FOLFOX (12 rds w/full oxi)
8/14 - Chemo finish
8/25 - CT- Inc
9/5 - clean PET
12/10- clean CT
2015
3/2 - Clean colonoscopy & port removed
3/4- clean CT
9/21- clean CT
2016
3/23- clean CT
2017
2/22- clean CT
2018
3/21 - clean CT
4/11 - clean colonoscopy
2019
3/11 - clean CT
9/23 - Five-year release - Annual visits now !
Next colonoscopy - 2023

ONE DAY AT A TIME !

Jachut
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Re: Laporascopic or open surgery for colon cancer

Postby Jachut » Tue May 17, 2016 4:06 am

My surgeon was confident that laparascopic ULAR was the best choice for me, I wasn't going to argue. Its so much easier to recover from.

Buckeye
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Re: Laporascopic or open surgery for colon cancer

Postby Buckeye » Tue May 17, 2016 5:51 am

Had laparoscopic LAR With TME. Very minimal scarring. The surgeon has to be skilled. I had Rectal cancer and it was small less than 1cm. Everything has turned out great so far.
Dx 10/20/15 stage 1 T1N0M0 1.3cmx1.1cmx1cm low grade ( well to moderately differentiated) Rectal cancer age 47
Loving Husband and father of two girls age 19 & 15 Sole income provider
CEA <0.5
CT, MRI and PET show no metastatic spread
LAR Laparoscopic TME 11/30/15 with Illo
Pathology clean no lymph node or vascular involvement. Confirmed Stage1
No chemo/rad cancer free now and forever.
Illo reversal 01/26/16

Carolinabluetec
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Re: Laporascopic or open surgery for colon cancer

Postby Carolinabluetec » Tue May 17, 2016 7:32 am

Absolutely choose laparoscopic if given an option. I was fortunate to have a very skilled colorectal surgeon that performed my procedure using the DaVinci robot. I had surgery Thursday morning and I was home walking my dogs on Saturday afternoon. On Monday, I walked 3.5 miles in a hilly area. I suffered no ill effects from the surgery. Too bad my chemo did not go as well. :(
03/14 DX Adenocarcinoma Sigmoid Polyp
05/14 Da Vinci Sigmoid Colectomy
06/14 T3N0Mx, staged IIa
07/14 Xeloda 3000 mg/day 14 on/7 off 8 rounds
12/14 Finished Chemo
01/15 CT NED :D
07/15 Colonoscopy NED :D
08/15 CT NED :D
03/16 CT NED 8)

nickr
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Re: Laporascopic or open surgery for colon cancer

Postby nickr » Tue May 17, 2016 7:43 am

Carolinabluetec wrote:Absolutely choose laparoscopic if given an option. I was fortunate to have a very skilled colorectal surgeon that performed my procedure using the DaVinci robot. I had surgery Thursday morning and I was home walking my dogs on Saturday afternoon. On Monday, I walked 3.5 miles in a hilly area. I suffered no ill effects from the surgery. Too bad my chemo did not go as well. :(

Thank you, we have a consultation at the end of month with a surgeon who does laparoscopic. Good to hear about the positive results from this forum, sorry about the chemo.

SurvivorsSpouse
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Re: Laporascopic or open surgery for colon cancer

Postby SurvivorsSpouse » Tue May 17, 2016 7:53 am

You need a colorectal surgeon, not a general surgeon, at a high volume center. Studies are showing that Lap surgeries are just as effective at treating colorectal cancer given similar circumstances. If the laparoscopic approach is too difficult, the surgeon will convert to an open procedure.

Recurrence rates for open or laparoscopic surgeries are due in large part to the skill and experience of the surgeon. A surgeon needs to take a complete specimen, including the complete tissue surrounding the colon/rectum and needs to harvest an adequate number of lymph nodes for pathology. Additionally, there are disection techniques that ensure that nerves are not damaged and the specimen is not damaged, leaving tumor behind.

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BrownBagger
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Re: Laporascopic or open surgery for colon cancer

Postby BrownBagger » Tue May 17, 2016 8:27 am

I had the choice and I told the surgeon I wanted open surgery because I wanted him to have all the access he needed to get the job done. He shrugged and said it makes no difference, other than lapro takes a lot longer. That was 7 years ago. He was no fan of the robot. Called it gimmick. "But they bought it and now everyone is expected to use it."

I am impressed by the greatly improved recovery times offered by lapro, however. Sounds like a good choice for that reason alone.
Eric, 58
Dx: 3/09, Stage 4 RC
Recurrences: (ongoing, lung, bronchial cavity, ribs)
Major Ops: 6/ RFA: 3 /bronchoscopies: 8
Pelvic radiation: 5 wks. Bronchial radiation—brachytheray: 3 treatments
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Current Chemo Cocktail: Xeloda & Erbitux & Irinotecan biweekly
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eleven11
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Re: Laporascopic or open surgery for colon cancer

Postby eleven11 » Tue May 17, 2016 8:52 am

My mom had the top surgeon in Chicago who has the skill sets to do laparoscopic, however, her tumor was in a very low and difficult to access to location so he did it open. Also, for her, it would have mean the difference between a permanent ostomy vs not having a permanent ostomy.
11/11 Mom dx @ age 50 T3M0N0
2012 12 tx FOLFOX
12/13 2 lung nodules
1/14 VATS wedge
3/14-present 5FU
4/15 Lobectomy RML

tarheelmom
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Re: Laporascopic or open surgery for colon cancer

Postby tarheelmom » Tue May 17, 2016 9:27 am

My surgeon said that the operation is the same (open, lap, robot) just with a variation in access. His preference was to start lap but move to open if he needed to in order to get the best outcome. He is a colorectal surgeon at a large, academic hospital and performs 1-2 LAR/week. My tumor was very low. Also in talking to friends who spend a lot of time in operating rooms, their insight was that the younger surgeons tended to prefer lap since that was a lot of their training vs. the older surgeons who tended to prefer open since that had been the bulk of their experience. I ended up with lap - very straightforward recovery from the incisions. Still felt like I had been kicked in the stomach by a mule, but it was more uncomfortable than painful. Surgery took about 5 hours. Started at 8 AM and first sample was sent to pathology at 10:45 am. Removed 35 cm of colon plus rectum and mesorectum. 3 incisions - one in navel, one above navel, and the ileostomy. When I asked the surgeon about the robot, his view was that he didn't need it and it required larger ports (hence larger incisions) than then traditional lap.
52 y at dx, mom to 4
DX: RC on 2/22/2016
Stage I, T2N0M0, 0/32 LN
23 mm x 7 mm moderately differentiated invasive adenocarcinoma
3 cm from anal verge
4/12/16: ULAR, TME, & temp ileostomy
6/14/16: ileo reversal

Carolinabluetec
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Re: Laporascopic or open surgery for colon cancer

Postby Carolinabluetec » Tue May 17, 2016 11:29 am

I chose the robot because my surgeon said "it makes me a better surgeon". That was all I needed to hear. Actually there were two surgeons involved. My surgeon operated the robot seated at a console while a second surgeon position the robot at table side. I worked in the medical equipment field my entire life, so if a surgeon says something is making him better, I listen. He is relatively young surgeon (40's) so he would tend to embrace technology rather than a more "mature" one.
03/14 DX Adenocarcinoma Sigmoid Polyp
05/14 Da Vinci Sigmoid Colectomy
06/14 T3N0Mx, staged IIa
07/14 Xeloda 3000 mg/day 14 on/7 off 8 rounds
12/14 Finished Chemo
01/15 CT NED :D
07/15 Colonoscopy NED :D
08/15 CT NED :D
03/16 CT NED 8)

beck1965
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Re: Laporascopic or open surgery for colon cancer

Postby beck1965 » Tue May 17, 2016 1:18 pm

DaVinci Robotic for me. Highly respected surgeon in this area said it was his method of choice. Said he hasn't done an "open" resection in a very long time. Less scaring, less recovery time and less pain. Fewer days in the hospital too. Make sure your surgeon is a "Colorectal Surgeon", not a general surgeon. Educate yourself on all options and do a little homework on your surgeon as well.
*50 y/o Female
*Sigmoid Mass found on routine colonoscopy/Feb 2016
*4cm villious lesion found at the rectosigmoid
*Surgery three weeks later to remove 13" of Sigmoid/resection
*Used DaVinci Robotic surgery
*Stage 1 rectosigmoid cancer/T1/N0/M0 = 18 negative nodes
*Acute renal failure during recovery, unknown reason[/b]
*Clear colonoscopy one year post resection!!
*Normal CEA's since surgery
*NED two years out.

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H is for Hawk
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Re: Laporascopic or open surgery for colon cancer

Postby H is for Hawk » Wed May 18, 2016 8:42 am

For laporoscopic surgery, confirm that the surgeon will be inserting the resected colon in a small plastic bag, this will prevent seeding of malignant cells at the port location when the tumor is removed from your body.
H is for Hawk (57)
10/14 L. hemi-colectomy 3 x 4 x 1 cm tumor, 13/14 lymph nodes pos. pT4a N2B M0 stage 3 MSS
11/14 - 4/15 12x FOLFOX
5/15 PET scan: 2.5 x 1.5 cm l. colon lesion, peri surface lesion SUV 2.4, adenocar., KRAS wd, BRAF V600E mut
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8/16 6700, FOLFIRI
9/16 4900, CT scan - two new liver mets
10/16 2255 vinorelbine

Nik Colon

Re: Laporascopic or open surgery for colon cancer

Postby Nik Colon » Wed May 18, 2016 6:10 pm

nickr wrote:but am concerned with higher recurrence rates at the ports

Can you link where you seen that as what I read that was not the case.
If you have skilled surgeons that should not be an issue. Both are around equal in many areas, and as far as cost about equal also based on time of stay and other factors (equal eachother out). But overall, lap did have slightly better overall statistics. Lap takes longer op time, but overall stay longer for open. Many other factors which I can't remember all, but if I had to choose, I would go with what the specific Dr was better at. Or seek one out which ever you choose. Jmo


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