WSJ: New devices for rectal cancer surgery reduce need for colostomies

Robert Cima

New medical devices for rectal cancer surgeries are helping patients forgo colostomies, shifting more individuals toward a new procedure that requires fewer external adjustments, according to medical experts.

Treatment for rectal cancer "has undergone significant improvements over the last 20 years on all fronts," Robert Cima, a colorectal surgeon at Rochester, MN-based Mayo Clinic, told The Wall Street Journal. And that means fewer patients with the disease are getting colostomies, or a procedure that diverts bodily waste through an opening in the abdomen.

Instead, surgeons are turning to sphincter-sparing procedures, which reconnect and preserve bowels with margins of less than one centimeter of healthy tissue. Better surgical staplers are part of the reason these procedures are possible, the WSJ reports, as before the devices were not precise enough to deal with small amounts of tissue. A study of 48,000 U.S. patients shows that the rate of sphincter-sparing procedures shot up to 60.5% in 2006 from 35.4% in 1988, according to data seen by the newspaper. Another study with 5,000 U.S. veterans found that the procedures rose to 79.3% between 2005 and 2010.

Still, there are a few obstacles for sphincter-sparing procedures with surgical staplers. As the WSJ article notes, several studies show that smaller towns and hospitals that perform fewer rectal cancer surgeries are not using the procedure, and often turn to colostomies instead. And the risk of rectal cancer coming back after sphincter-sparing procedures and colostomies is about the way, doctors told the newspaper.

Meanwhile, for some patients who undergo colostomies, an improved design for related devices is helping improve their quality of life. Colostomy bags, or pouches, are lighter and thinner, and adhesives attaching them to the body are more secure, the WSJ story points out. Irrigation devices also allow patients to clean out the system themselves, controlling the timing and letting some individuals wear smaller pouches between sessions.

- read the WSJ story (sub. req.)

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