Colorectal (Pelvic) Surgery

Introduction

The Colorectal and Pelvic Surgery Division was established 8 years ago. Its main purpose is to bring together the divisions that are composed of colorectal surgeons and urologists. Cooperation between these divisions contributes not only to the establishment of effective operative techniques but also to oncological consensus including consensus on the quality of life (QOL) of patients with pelvic malignancies. New surgical procedures, such as nerve-sparing surgery, sphincter-saving surgery, bladder-sparing surgery, and pouch surgery, are being developed to prevent postoperative dysfunction. These new approaches will contribute to better QOL among patients with pelvic malignancies.

Routine Activities

The Colorectal and Pelvic Surgery Division　comprises 7 consultants (5 colorectal surgeons and 2 urologists) and 7 residents. The outpatient clinic is open 5 days a week. More than 300 new patients with colorectal carcinomas and more than 100 new patients with other pelvic malignancies visited this Division during the last year. Treatment plans are discussed at a weekly conference on GI malignancies and at another weekly conference on pelvic malignancies. Many treatment modalities, such as local excision with or without adjuvant chemo- or radiotherapy and other minimally invasive forms of surgery using laparoscopy, have been introduced for treatment of patients in the early stages of cancer. Laparoscopy-assisted operations (Lap-Ops) with wider lymphadenectomy of up to more than D2 are also increasingly being performed in patients with advanced colorectal carcinomas. Abdominoperineal resection (APR) has, in the past, been the standard surgery in patients with very low rectal cancer; however, partial anal sphincter preservation surgery has been performed in >160 patients with very low rectal tumors and has resulted in cure, preservation of anal function, and better QOL.

● N. Saito, M. Sugito ●

Number of cases operated upon by the Colorectal (Pelvic) Surgery Group during 2003–2007
Colorectal carcinoma cases Other cases
Year Total number Colon Rectum Subtotal Gastrointestinal Urological Others
2003 417 129 111 240 69 29 79
2004 480 161 122 283 32 76 89
2005 449 138 125 263 14 106 66
2006 546 158 168 326 8 137 75
2007 524 149 183 332 7 121 64
Total 2,416 735 709 1,444 130 469 373

Table of Contents