Endoscopic surgery via natural orifices to treat colorectal cancer

Award: – The First Prize of Vietnam National Technology Innovation Competition in 2015 – The First Prize of Thua Thien Hue Technology Innovation Competition in 2015

Authors: Pham Nhu Hiep, Ho Huu Thien, Pham Anh Vu, Phan Hai Thanh, Nguyen Thanh Xuan, van Tien Nhan, Tran Nghiem Trung, Pham Trung Vy, Pham Xuan Dong, Mai Trung Hieu, Dao Le Minh Chau.

Unit: Hue Central Hospital

Colorectal cancer (CC) is a common disease in the world as well as in Vietnam. Each year, there are 11 million new cases of colorectal cancer worldwide. In our country, data from Hanoi showed that colorectal cancer ranks fifth in men and women after lung, stomach, liver and breast cancer. Infection rate by age of the disease is 7.5/100,000 people.

Laparoscopic colorectal surgery via natural orifices is a type of surgery in which all surgical instruments are inserted through the vagina or anus for dissection, dissected parts are then collected and the opening is sewn only via this route, there is no need for open abdominal surgery. This is different from traditional endoscopic colorectal surgery where most incisions are abdominal. This is consistent with the world trend of minimally invasive surgery.

Assoc. Prof. Pham Nhu Hiep – Project Manager, said “at Hue Central Hospital, we have been conducting anal natural orifice translumenal surgery (NOTES) for low rectal cancer patients since 2007, and has been reported at national and international conferences. We successfully performed 20 colorectal surgeries via natural orifices (4 cases via vaginal orifice). At present, no institutions in Vietnam have announced a full laparoscopic colorectal surgery via natural orifices. Therefore, it can be said that we are the first to adopt and have mastered this technique.

Advantages of laparoscopic surgery in treatment of colorectal cancer is shortened duration of stay at hospital, less pain for patient… Also, in rectal and pelvic cases, laparoscopic surgery provides better manipulation and observation than open surgery. Especially in laparoscopic surgery, complications are less likely to happen and is somewhat lower than open surgery. The hospitals have recently employed new techniques such as ultrasonic scalpel, cauterizing scalpel, single port access surgery, single incision laparoscopic surgery, natural orifice translumenal endoscopic surgery (NOTES), …thus further enhance endoscopic surgery in such fields.

Compared with previous achievements of colonoscopic surgery, natural orifices endoscopic surgery is a comparably new technique in Vietnam. This will be one of the key milestones in laparoscopic colorectal surgery of Vietnam. This is a minimally invasive procedure, which utilizes natural orifices to set up the instrument thus causes less pain for patients, postoperative recovery time is faster, less time-consuming……

The Hue Central Hospital and other hospitals across the country now have a new, effective and safe technique for the treatment of colorectal cancer. It may bring benefits to both hospitals and patients. For hospitals, it will improve reputation and treatment quality of the hospitals; for patients, it will reduces costs, hospitalization time, causes less complication, and has higher aesthetic value…

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