Colon cancer: minimally invasive surgery in Chivasso

Colon cancer is among the most frequent cancers in our country, ranking third (after prostate and lung ) in men and even second (after breast) in women. In 2019, new colon cancer diagnoses expected in Italy are 49,000 (27,000 men, 22,000 women). Mortality, thanks in part to screening programs, has been steadily declining for years. Early detection makes it possible to arrive at a high cure rate for this cancer; now genetic tests on blood and stool are beginning to be available that can identify the risk of developing colon cancer very early. This is tato more important as, in recent years, the average age at which colon cancer appears has lowered.

Treatment of colon cancer is surgical, and consists of removing the tumor itself then reconstructing the integrity of the colon in order to allow stool transit.

colon cancer, colon cancer, colon anatomy
Anatomy of the colon

The colon, from an anatomic-surgical point of view, is divided into regions: cecum, ascending colon, hepatic flexure, transverse colon, splenic flexure, descending colon, sigmoid colon, and rectum; cancer can affect any of these districts. The clinical manifestations of colon cancer vary depending on which district is affected: cancer of the cecum and ascending colon, for example, is less frequent, more typical of the elderly, and most often manifests with anemia; cancer of the descending colon or sigmoid colon is more frequent and most often presents with symptoms of bowel obstruction and/or rectorrhagia (bleeding from the anus).

Today, the gold standard for this surgery is laparoscopic surgery: whereas until a few years ago it was necessary to perform a laparotomy, that is, a large cut from the sternum to the pubis, to gain access to the colon, today, the same surgery can be performed through 3-4 small holes in the abdominal wall, and a minimal cut, usually above the pubis, to extract the tumor from the abdomen once it has been removed.

Colon cancer, colon cancer, laparoscopic surgery
Laparoscopic hemicolectomy surgery

L'laparoscopic removal of the colon, especially of the cecum and ascending colon, is a technically complex operation: this is why many surgeons do not perform it, continuing to perform the traditional cut. However, in experienced hands, it ensures a complete removal of the tumor and lymph nodes (possible site of metastasis), very significantly reducing postoperative pain and accelerating the functional recovery of patients and their return to home and their activities: typically, a patient undergoing laparotomic (i.e., traditional cut) removal of colon cancer remains hospitalized 7-10 days, while for a patient whose colon cancer has been removed laparoscopically, the hospital stay is 4-5 days.

colon cancer, colon cancer, laparotomy, laparotomy scar
The laparotomic scar after removal of colon cancer

Laparotomy leaves a large scar and can itself be the cause of disease, typically the formation of a laparocele, which is an abdominal hernia that appears on the laparotomy scar. These are often very large hernias, which can only be repaired once a suitable period of time has elapsed after the tumor has been removed, with surgery that is not infrequently very demanding on the patient-even more complex than the removal of colon cancer. In such cases, the patient's quality of life deteriorates significantly: abdominal pain, back pain, breathing difficulties may appear, as well as all the typical complications of laparocele, such as incarceration and very dangerous stricture.

In contrast, the risk of laparocele is almost zero when the patient is operated on laparoscopically.

colon cancer, colon cancer, laparoscopic scarring, laparoscopy
Typical appearance of scars after laparoscopic surgery

In our hospital in Chivasso, I perform laparoscopic surgeries for the removal of colon cancer (bothright hemicolectomy, in cases of cancer of the cecum, ascending colon, hepatic flexure, and first portion of the transverse colon; andleft hemicolectomy, for cancer of the descending colon, sigmoid colon, splenic flexure, and second portion of the transverse colon); in particular, I was the first, and currently I am still the only one, to perform right hemicolectomy laparoscopically.

For more information you can reach me by filling out the form below, emailing info@cuccomarinomd.com, sending me a WhatsApp message or calling 01119903768.

 

FOR INFORMATION

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Dr. Salvatore Cuccomarino
Medical Surgeon Specialist in General Surgery
Digestive system surgery, laparoscopic colon surgery, endoscopic rectus diastasis (REPA) and laparocele surgery, hernia surgery, coloproctology
Studio De Medica - Galileo Ferraris course 12
Chivasso,TO
10141
EN
Phone 01119903768