Missing elements of modern management

doi:10.1136/bmj.39388.457662.1F

BMJ 2007;335:953 (10 November), doi:10.1136/bmj.39388.457662.1F

Letters

Colorectal cancer

Missing elements of modern management

The first 150 words of the full text of this article appear below.

Ballinger and Anggiansah's review of the management of colorectalcancer made little or no mention of important aspects of currenttreatment.¹

They did not mention the role of laparoscopic large bowel resectionfor colorectal cancers, which has become increasingly widelyused in the United Kingdom and abroad and is now recommendedas an alternative to open surgery by the National Institutefor Health and Clinical Excellence (NICE ).² A recent studyhas shown that laparoscopic surgery allows rapid mobilisationof the patient, an earlier return of bowel function, lower complicationrates and a much earlier discharge from hospital (4 days v 11days).³

Secondly, liver resection, for unilobar or bilobar colorectaltumour metastases, has revolutionised treatment of the conditionyet only merits one sentence. Up to 50% of patients with colorectalcancers develop liver metastases after diagnosis. Chemotherapyhas been shown to extend median survival. However, without liverresection, five . . . [Full text of this article]

W J Fawcett, consultant anaesthetist, J T Lordon, surgical research fellow, N F Quiney, consultant anaesthetist, N D Karanjia, professor of surgery, T A Rockall, professor of surgery