Colon Cancer: Laparoscopy Also Successful Treatment
"For a long time, many surgeons have been afraid that laparoscopy might impair survival in colorectal cancer patients and cause metastases in the skin openings that are used to insert the instruments, but this has proven not to be the case," said lead reviewer Esther Kuhry, M.D., a general surgery resident at Namsos Hospital in Norway.

In a meta-analysis that combined the results of 12 trials involving 3,346 patients, the reviewers compared outcomes of laparoscopic and open surgeries used in colorectal cancer treatment and found no significant differences between the two types of surgeries when it came to long-term survival and cancer recurrence rates.

Based on the review results, "Å“laparoscopic surgery for colon cancer is associated with survival and mortality rates that are equal to open surgery," Kuhry said. The review found no significant differences between the two groups in terms of cancer metastasis, short-term and five-year survival rates and deaths caused by cancer. T

he reviewers also evaluated the incidence of adhesions - bands of scar tissue that form between organs and tissue - and hernias at the incision site, two common complications after colorectal cancer surgery. They found no significant differences in the rates of these complications between the laparoscopic and open surgery groups.

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What Women Should Know About Prevention and Treatment

Pelvic pain that is chronic and debilitating, and affects your emotional and sexual health...

Infertility that interrupts your plans for a family, your hopes and dreams for the future...

These are two of the major problems that post-surgical pelvic adhesions can cause. Pelvic adhesions are abnormal bands of scar tissue that form in the pelvis and cause organs to stick or bind to one another. Adhesions occur in the majority of women who have pelvic surgery. And yet, many women don't know about adhesions and don't discuss the subject with their doctors before having gynecologic surgery - or afterwards when these problems develop. But you should.

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An adhesion is a band of scar tissue that binds together two anatomic surfaces which are normally separated from each other.

Description of Adhesions
Adhesions are most commonly found in the abdomen, where they form after abdominal surgery, inflammation or injury. Adhesions are fibrous tissues within the body that join normally unconnected parts. Although sometimes present from birth, adhesions are usually scar tissue formed after inflammation. The most common site of adhesions is the abdomen, where they often form after peritonitis (inflammation of the abdominal lining) or following surgery, as part of the body�s healing process.

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Despite doubts as to the relationship between ADHESIONS and pain, several studies show that lysis (cutting, adhesiolysis) (photo) of ADHESIONS provides some relief.

In a study in Germany (Frey et al., 1994) 58 (40 female, 18 male) patients with chronic abdominal pain underwent laparoscopy.  Other than adhesions, there were no abnormal findings.  The ADHESIONS were then cut (adhesiolysis) and the patients’ pain was assessed up to 30 months later.  There was a complete remission of pain in 45% of the patients, with 35% of patients reporting a substantial improvement.  Pain persisted in 205 of the patients.  Similar figures were reported by a Swiss group (Mueller et al., 1995).  American surgeons such as Steege and Stout (1991) and Daniell (1989) have also reported improvement in pain after adhesiolysis.

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Endometriosis refers to a condition in which endometrial tissue that normally lines the uterus is found in other areas of the body. It may appear on or near the reproductive organs or within the abdominal cavity. When it appears, it causes inflammation, often accompanied by adhesions that form to help the body heal from the inflammation. Adhesions from endometriosis can join structures with strong glue-like bonds that can last a lifetime (see our general adhesions page for more detail.)

Adhesions, endometriosis, pain, and dysfunction are intimately related. Adhesions from endometriosis can cause pain anywhere in the body ( abdomen, pelvis, low back). Dysfunctions such as poor digestion, irritable bowel, and infertility may also result from the adhesions and endometriosis. We believe that the pull of adhesions on pain-sensitive structures is what causes the severe, debilitating pain in many women with endometriosis.

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Labial adhesions occur when the labial skin around the vagina becomes irritated and sticks together. It is most common in young girls between the ages of 3 months and six years and is usually not a cause of concern. The adhesions may be mild, in which only part of the vaginal opening is closed, or they can cover the complete vaginal opening.
Mild cases can be treated by applying a bland ointment or diaper rash cream to the labial skin each day and gently separating it over a few weeks. Severe cases, especially if it is blocking urine or vaginal secretions, usually require treatment with a topical estrogen cream (Premarin) and gradual separation of the labia. It is important to apply the cream only to the area of the adhesion (using a cotton tip applicator can be helpful), rub it in, and then try to gently separate the adhesion.

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Pelvic pain can have many different causes. For example, pain can be caused by a gynecologic condition such as endometriosis, uterine fibroids, ovarian cysts and pelvic adhesions. It also can be the result of an intestinal, urinary or muscular problem. Pelvic pain can even be a manifestation of stress or depression.

Pelvic Adhesions: Adhesions are bands of scar tissue that bind organs together. They are created by previous infections such as appendicitis or pelvic inflammatory disease, by pelvic or abdominal surgery or by endometriosis. Symptoms from adhesions include generalized pelvic discomfort or localized pain. Adhesions can be difficult to diagnose, however in some cases, the uterus and ovaries feel bound together on pelvic examination. A definitive diagnosis of adhesions is usually made during surgical exploration, frequently via laparoscopy. Surgery to cut bands of scar tissue can relieve pain. However, sometimes the adhesions re-form.

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