Is Radical Bowel Cancer Resection Under Local Anaesthesia and Sedation Feasible?

Area of Science:

• Surgical Oncology
• Anesthesiology
• Gastroenterology

Background:

• Bowel cancer patients with severe comorbidities are often unfit for major surgery under general anesthesia.
• Surgery offers the only chance for cure in bowel cancer, but lack of it leads to poor symptom control.

Purpose of the Study:

• To investigate the feasibility of performing bowel cancer resections under local anesthesia in high-risk patients.
• To assess outcomes for patients deemed unfit for general anesthesia.

Main Methods:

• Eight elderly patients (77-89 years) with significant comorbidities underwent standard cancer resections under local anesthesia and sedation.
• Procedures included hemicolectomies, Hartmann's procedures, and transverse colectomies.
• Patients were carefully selected and underwent a thorough assessment, including P-POSSUM scoring.

Main Results:

• Seven of eight patients survived radical surgery without complications.
• One patient died 8 months post-surgery from an unrelated cause.
• One postoperative death occurred due to cardiogenic shock on day three.

Conclusions:

• Radical cancer resections under local anesthesia are feasible in carefully selected high-risk patients.
• This approach offers acceptable mortality and comparable medium- to long-term results.
• Local anesthesia provides a viable alternative for patients unfit for general anesthesia.