Innovative surgery treats stomach, intestinal cancers

Patients spend less time in hospital, recover faster with less pain

CALGARY – Patients undergoing surgery for early-stage stomach and intestinal cancer are recovering faster and going home sooner as a result of a new surgical approach.

In December, a multi-disciplinary team from the Peter Lougheed Centre (PLC) in Calgary became the first in the Prairie provinces to adopt a new, minimally invasive surgical method for removing cancerous tissue from the gastrointestinal (GI) tract. The team – comprised of gastroenterologists, endoscopic surgeons, anesthetists, pathologists, as well as nurses and other professional care staff – has successfully treated eight patients to date using this method, with three more to undergo the procedure in March.

The eight patients were discharged home within 24 hours of surgery and none required hospital readmission. In general, patients require little or no medication for post-op pain control, and recover more quickly compared to patients who undergo traditional cancer operations.

There are plans to formally introduce this procedure in Edmonton later this year.

“What a boon for patients in Calgary, to be able to experience this cutting-edge surgical technique that reduces pain and boosts recovery,” says Tyler Shandro, Alberta’s Minister of Health. “This type of work attests to the amazing skills and knowledge of the physicians and the surgical and research teams who provide the best possible medical care to Albertans. I’m pleased to see innovations like this shared so all Albertans can benefit. Thanks, too, to AHS, Calgary Health Trust and the generous donors who helped equip this project for success.”

Before this new technique became available, patients undergoing surgery for these types of gastrointestinal cancers would typically remain in hospital for several days and have a recovery that could last up to six weeks.

“Treating most cancers of the GI tract has previously meant removing significant portions of the stomach or intestines, resulting in a lengthy recovery time and long-term effects that can include the need for permanent measures, such as a colostomy. This can have considerable impacts on eating habits and lifestyle,” says Dr. Paul Belletrutti, a local gastroenterologist performing this new intervention in Calgary and a clinical associate professor at the University of Calgary. “With this minimally invasive technique, we can remove just the cancerous tissue without removing an entire section of the GI tract, which leads to a faster healing time, less pain, a shorter length of hospital stay and fewer potential long-term complications.”

This new surgical technique utilizes a small flexible video camera, called an endoscope, which is inserted into the GI tract through the mouth or anus. The endoscope contains a bright light and high-definition video camera that projects real-time images of the GI tract onto a monitor.

Specially trained endoscopists, with input from the entire surgical care team, visualize and remove cancerous tissue from the esophagus, stomach, small intestine, colon or rectum, using small tools inserted through the endoscope, leaving the rest of the organs and entire GI tract in place.

“This is an incredible accomplishment and a great example of how teamwork and innovation can create significant advancements to benefit patient care,” says Dr. Mark Swain, Section Head, Section of Gastroenterology and Hepatology, in the Calgary Zone of Alberta Health Services (AHS), and Head, Division of Gastroenterology and Hepatology at the U of C. “While patients do need to meet certain qualifications to undergo this procedure – including the type, stage and extent of the GI tract cancer – we are working to make this treatment option widely available across southern Alberta. We are putting the people, tools and organizational structures in place to make this happen.”

Andy Blundell, 68, was diagnosed with cancer of the esophagus three years ago but was advised not to undergo traditional surgery due to the potential of complications from his other health conditions. He was chosen to become the first patient to undergo the less invasive, endoscopic surgery in December, and had a scheduled followup surgery in February to remove a second tumour. “I enjoyed breakfast at home the next morning, less than 24 hours after my surgeries,” says Blundell, who was out playing snooker the following afternoon, and back to enjoying exercise a few weeks after surgery.

Cancer of the GI tract affects about 6,000 Albertans each year. If treated in its early stages, these cancers can be cured and most individuals have a near normal life expectancy.

“Dr. Belletrutti has built on the work of the gastrointestinal endoscopy unit at the Peter Lougheed Centre to establish a centre of excellence for interventional endoscopy procedures and provide cutting-edge, efficient and cost-effective centralized care to southern Albertans with digestive diseases,” says Dr. Sid Viner, Zone Medical Director in AHS Calgary Zone. “Having this type of surgery done in a minimally invasive way and going home within the same day would have been unheard of even a few years ago.”

The specialized video equipment and monitors required to perform this procedure were provided through $100,000 in funding from Calgary Health Trust, the charitable partner for the city’s hospitals, care centres and health programs.

“This new procedure is a wonderful example of how healthcare philanthropy brings world-class innovation to Alberta and has the ability to change outcomes for individuals and their families,” says Calgary Health Trust President and CEO Mike Meldrum. “Support from the community has allowed us to identify investments such as this that make a significant improvement for Albertans, and support our physicians and care teams in their pursuit to provide the best outcomes for patients.”

The Calgary Health Trust fundraises for health care in Calgary. The incredible generosity of donors has led to advancements in patient care, clinical research and education. Funds raised benefit Foothills Medical Centre, Peter Lougheed Centre, Rockyview General Hospital, South Health Campus, many community health programs and 12 Carewest care centres in our community.

Alberta Health Services is the provincial health authority responsible for planning and delivering health supports and services for more than four million adults and children living in Alberta. Its mission is to provide a patient-focused, quality health system that is accessible and sustainable for all Albertans.