Laparoscopic Surgery for Rectal Tumors: What You Need to Know

Laparoscopic Surgery for Sigmoid Colon Tumor

Hello Dr.
Hou, my mother is 54 years old and has been experiencing bloody stools for many years.
She underwent a colonoscopy at a clinic, and a non-regular tumor was found approximately 15 cm from the anus in the sigmoid colon, measuring about 0.3 x 0.2 x 0.2 cm, with ulceration and bleeding.
I would like to ask: (1) Based on the size of the tumor, what stage is it likely to be? (2) If surgery is required, can laparoscopic surgery be an option? How many days would she need to be hospitalized? What would be the out-of-pocket expenses? (3) Is it necessary to use so-called "targeted therapy" for treatment? How long would she need to take it, and what would the costs be? Thank you, Bonnie.

Bonnie, 30~39 year old female. Ask Date: 2009/03/26

Dr. Hou Yongji reply Surgery

1.
Currently, the staging of colorectal cancer is based on the depth of tumor invasion into the bowel wall, the involvement of surrounding lymph nodes, and whether there is distant metastasis (to the liver or lungs).
Therefore, if staging is determined solely by endoscopic diagnosis, it can only be speculative and cannot provide precise staging.

2.
Laparoscopic surgery is an option, but it requires good equipment and experienced surgeons to perform the procedure.
The standard hospital stay is typically 5 to 7 days post-surgery.
Currently, the charging standards vary among hospitals; our institution charges based on the equipment used.
3.
According to health insurance regulations, only patients with stage IV (advanced) colorectal cancer are eligible for targeted therapy, which usually consists of 12 to 18 sessions, depending on the treatment response.
The cost is at least 500,000 to 800,000 NTD or more.
4.
Based on your description, please first confirm whether the biopsy report indicates malignancy.
Then, discuss with your physician regarding subsequent treatment.
For a tumor measuring approximately 0.3 x 0.2 x 0.2 cm, a colonoscopic laparoscopic resection can be considered for initial diagnosis and treatment.
If the tumor invasion depth is too significant, surgical treatment should be reconsidered.
Dr.
Hou Yong-ji.

Reply Date: 2009/03/26

More Info

Hello Bonnie,
Thank you for your inquiry regarding your mother's recent diagnosis and potential treatment options for the rectal tumor. I understand that this is a concerning situation for you and your family, and I will do my best to provide you with comprehensive information regarding laparoscopic surgery and related aspects.

1. Tumor Staging: The size of the tumor is an important factor in determining its stage, but staging also considers other factors such as depth of invasion, lymph node involvement, and metastasis. Based on the size you provided (0.3 x 0.2 x 0.2 cm) and the fact that there are ulcerative and bleeding characteristics, this could suggest that the tumor is at least Stage I, possibly Stage II if it has invaded deeper layers of the rectal wall. However, a definitive stage can only be determined through further imaging studies and possibly additional biopsies.

2. Laparoscopic Surgery: Laparoscopic surgery is often a preferred method for removing rectal tumors due to its minimally invasive nature, which typically results in less postoperative pain, shorter recovery times, and reduced hospital stays compared to traditional open surgery. Whether your mother is a candidate for laparoscopic surgery depends on several factors, including the tumor's location, size, and the surgeon's expertise. Generally, if the tumor is accessible and there are no contraindications, laparoscopic surgery can be performed. The length of hospital stay can vary, but patients often stay for 1 to 3 days post-surgery, depending on their recovery progress.

Regarding the costs, this can vary widely based on your location, the specific hospital, and whether your mother has insurance coverage. It is advisable to consult with the hospital's billing department or your insurance provider to get a clearer picture of potential out-of-pocket expenses.

3. Targeted Therapy: The need for targeted therapy depends on the tumor's characteristics, including its histological type and molecular markers. For rectal tumors, particularly those that are classified as adenocarcinomas, targeted therapies may be considered if there are specific mutations or markers present. However, for small tumors like the one described, surgery is typically the first line of treatment. If the tumor is found to be more aggressive or if there is a risk of metastasis, then adjuvant therapies, including chemotherapy or targeted therapy, may be recommended. The duration of such treatments can vary, often lasting several months, and costs can also vary significantly based on the specific medications used and insurance coverage.

In summary, your mother’s treatment plan will be tailored based on the tumor's characteristics and her overall health. It is crucial to have a detailed discussion with her healthcare team, including a colorectal surgeon and possibly an oncologist, to explore all available options and make informed decisions.

I hope this information helps you and your family navigate this challenging time. Please feel free to reach out if you have any further questions or need additional clarification.
Best wishes for your mother's health and recovery.

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