ONCOLOGIC SURGERY

One of the most difficult types of surgery for an abdominal surgeon is oncologic surgery. Oncologic surgery involves both the resection phase (removal of part of the organs affected by the tumor) and the reconstructive phase (aimed at restoring anatomical conditions), and all the while focusing on protecting the patient from potential complications. The goal is to ensure a good, or at least acceptable, quality of life in terms of the patient’s motor functions, digestion, and bowel movement, as well as the function of the organs that operated on, limiting any potential long-term damage.

Oncologic surgery procedures must adhere to certain precise rules that are part of the surgeon’s knowledge base. These include a series of technical steps to ensure complete removal of the tumor, avoiding its rupture and spread, and includes the removal of nearby lymph nodes. These steps ensure the operation’s success in terms of tumor eradication and allows for proper staging, which is essential for classifying the disease classification. Staging provides prognostic elements and may stipulate the need for complementary treatments to resolve the oncologic issue.

To ensure the best care for the patient and their specific type of cancer, it is essential to consult with radiologists, oncologists, radiotherapists, pathologists, interventional radiologists, endoscopists, as well as other medical professionals, such as dietitians, physiotherapists, and nurses. These consultations are important during the perioperative period to establish treatment priorities and ensure the best care possible. This multidisciplinary team holds regular meetings analyze individual oncologic cases.

Preoperative treatment (such as chemotherapy or neoadjuvant radiotherapy) may be required to reduce the size of the primary tumor, allowing for a safer and more manageable operation with a reduced risk of distant metastases.

More recently, surgeries for liver, peritoneal, and lung metastases have become more common, as international studies have shown that, for certain types of cancers (e.g., colorectal, neuroendocrine), treating metastases can significantly improve the chance of survival and even lead to a full recovery.

Advances in anesthesia, resuscitation techniques, and medical treatments for cardiovascular diseases allow for more aggressive surgeries, even in older patients. However, it is important to remember that such procedures should only be performed in facilities with Intensive Care Units (ICU) and properly trained professionals.

Oncologic surgery can also be performed using minimally invasive techniques such as laparoscopy and robotic surgery.

Factors such as the tumor location, comorbidities (concurrent diseases), patient characteristics (age, body weight, previous surgeries), and the surgeon’s experience must all be considered when deciding on the best approach, whether it be open, laparoscopic, or robotic surgery.