Endoscopic Resection for Rectal Cancer treatment in the Best Hospitals in the World
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Department of General, Abdominal Surgery and Surgical Oncology
The Department of General, Abdominal Surgery and Surgical Oncology offers the full range of services in these medical fields. Whenever possible, operations are performed using minimally invasive techniques, which are the gold standard of modern surgery. The outstanding quality of medical care is confirmed by numerous prestigious certificates, including certificates from the German Cancer Society, the German Hernia Society, etc. In addition, the department provides innovative hyperthermic intraperitoneal chemotherapy (HIPEC), which is available only in the most progressive clinics in Europe.
Department of General and Abdominal Surgery, Colorectal Surgery, Hepatopancreatobiliary Surgery, Hernia Surgery and Bariatric Surgery
The Department of General and Abdominal Surgery, Colorectal Surgery, Hepatopancreatobiliary Surgery, Hernia Surgery and Bariatric Surgery provides the full range of surgical treatment in its field of competence. The department's highly qualified surgeons annually perform about 2,000 surgical interventions. Extensive clinical experience allows the specialists to perform even particularly complex operations. The department’s advanced operating rooms serve for surgery to treat gastrointestinal diseases, liver, gallbladder, bile duct, pancreatic, rectal, anal and colon pathologies. The medical facility also successfully performs operations to treat hernias: inguinal, umbilical, and anterior abdominal wall hernias. In addition, the department's doctors deal with the surgical treatment of morbid obesity. Minor traumatic laparoscopic interventions are considered the gold standard, which guarantee a patient minimal risks and rapid postoperative restoration. Surgeons tell the patient in detail about their upcoming treatment and, in every possible way, support them in their recovery.
Department of General and Abdominal Surgery, Colorectal Surgery, Endocrine Surgery and Hernia Surgery
The Department of General and Abdominal Surgery, Colorectal Surgery, Endocrine Surgery and Hernia Surgery offers the full range of modern surgical interventions in the areas of its specialization. Every year, the medical facility performs more than 2,500 surgical interventions on an inpatient and outpatient basis. The department has vast clinical experience in the field of minimally invasive surgery, which allows the patient to avoid severe pain and prolonged hospitalization. In addition, the department offers robotic surgery using the most modern models of the da Vinci surgical system. The medical facility has the status of the Reference Center for Minimally Invasive Surgery and Hernia Surgery. Surgical treatment of cancer is one of the department's clinical priority focuses. A large number of da Vinci robot-assisted interventions are performed here for gastrointestinal cancers. The department holds a leading position in the use of the da Vinci surgical system in the treatment of rectal and sigmoid cancer patients. The operating rooms of the medical facility are equipped with the very latest technology, while hygiene and safety standards are at the highest level as well. Prior to surgery, the patient undergoes a comprehensive examination. Doctors also assess the risks of the upcoming operation and its expected results. With appropriate clinical indications, preference is always given to minimally invasive surgery.
Department of General, Abdominal, Transplant, Hepatopancreatobiliary, Colorectal, Endocrine, Bariatric Surgery and Hernia Surgery
The Department of General, Abdominal, Transplant, Hepatopancreatobiliary, Colorectal, Endocrine, Bariatric Surgery and Hernia Surgery provides the full range of services in the areas of its specialization and holds a leading position at the national and international levels in terms of the number of surgical interventions performed and their success. Of particular interest are operations for treating diseases of the bowel, stomach, esophagus, pancreas, liver, gallbladder, and bile ducts, and endocrine glands. The department's doctors have excellent skills in the surgical treatment of cancer, surgery for liver, kidney, pancreas, and small intestine transplants, and operations for morbid obesity. The department's operating rooms are the pride of the medical facility, since they have all the necessary technical options for performing operations with the da Vinci surgical system, image-guided interventions, and endoscopic surgical procedures, which are characterized by minimal trauma rates.
Department of General and Abdominal Surgery, Hepatopancreatobiliary Surgery, Colorectal Surgery, Hernia Surgery
According to the Focus magazine, the Department of General and Abdominal Surgery, Hepatopancreatobiliary Surgery, Colorectal Surgery, Hernia Surgery is one of the best medical facilities in Germany for the treatment of colon, stomach, esophageal, pancreatic, and liver cancers! The main specialization is surgical procedures for malignancies in the intestines, stomach, esophagus, liver, pancreas, and rectum. The department also successfully operates on patients with chronic inflammatory bowel disease such as Crohn's disease and ulcerative colitis. The department's therapeutic capabilities are complemented by the treatment of gastroesophageal reflux disease, sigmoid diverticulum, umbilical and inguinal hernias, cholelithiasis, and anorectal disorders. Nearly all surgical procedures are performed using minimally invasive surgical techniques – the department has the status of a Center of Excellence for Minimally Invasive Surgery certified by the German Society for General and Vascular Surgery (DGAV). The medical facility also offers innovative da Vinci robot-assisted surgery. These procedures have become the standard of care for colon cancer, rectal cancer, and colonic diverticulosis. Each clinical case is evaluated individually and the surgical procedure is carefully planned. Surgeries are performed in high-tech operating rooms in compliance with hygiene and safety standards.
Department of General and Abdominal Surgery, Hepatopancreatobiliary Surgery, Colorectal Surgery, Endocrine Surgery, Hernia Surgery and Bariatric Surgery
The Department of General and Abdominal Surgery, Hepatopancreatobiliary Surgery, Colorectal Surgery, Endocrine Surgery, Hernia Surgery and Bariatric Surgery offers the full range of effective surgical treatments in accordance with modern medical standards. Operations of varying complexity are performed on the stomach, colon, pancreas, liver, gallbladder, bile ducts, rectum, thyroid gland, and parathyroid glands in the department's operating rooms every day. The department's primary focus is the surgical treatment of malignant gastrointestinal tumors. The medical facility is certified in this area by the German Cancer Society (DKG). The team of endocrine surgeons specializes in the treatment of diseases of the thyroid gland, parathyroid glands, and adrenal glands. Patients with morbid obesity are also successfully operated on here. In their work, the department’s specialists primarily use minimally invasive surgical techniques, which virtually eliminate trauma to healthy tissue during the intervention. The department's operating suite is equipped with an innovative da Vinci Surgical System, which allows the doctors to perform sparing and high-precision surgical interventions. The specialists of the medical facility strictly adhere to hygiene and safety standards and create the most comfortable conditions for each patient during their hospital stays.
Department of Abdominal, Thoracic and Vascular Surgery
The Department of Abdominal, Thoracic and Vascular Surgery offers all modern surgical interventions in these fields. Specialization covers the treatment of diseases of the abdominal organs, endocrine glands, pathologies of the lungs and chest wall, pathological vascular lesions of all parts of the body. In addition, kidney transplantation and pancreas transplantation are part of the surgeons' tasks. Whenever possible, operations are performed using minimally invasive techniques that have several advantages over classical interventions.
Department of Adult and Pediatric General, Abdominal, Transplant Surgery
According to Focus magazine, the Department of Adult and Pediatric General, Abdominal, Transplant Surgery ranks among the top German medical facilities specializing in bowel cancer treatment! The department performs surgical treatment of general surgical diseases, abdominal pathologies, and also specializes in organ transplantation. Of particular interest are surgical oncology of the abdominal organs, as well as pancreatic and liver surgery. The department annually performs more than 3,000 surgical interventions, which contributes to its credibility at the national level.
Department of General, Abdominal and Transplant Surgery
According to the Focus magazine, the Department of General, Abdominal and Transplant Surgery ranks among the top German departments specializing in bowel cancer treatment! The department offers the full range of services in these medical fields and guarantees the first-class medical care at the university level. The department specializes in the treatment of diseases of the abdominal cavity, esophagus and thyroid gland, transplantation of liver, kidney and pancreas. The medical facility has won the reputation of one of the three largest and most successful Transplant Centers in Germany. Also, within the clinical practice, doctors hold highly-specialized consultations on rare diseases and provide 24-hour emergency care.
Department of General, Abdominal, Adult and Pediatric Transplant Surgery
According to the Focus magazine, the Department of General, Abdominal, Adult and Pediatric Transplant Surgery ranks among the top German departments specializing in the treatment of bowel cancer! The department specializes in the treatment of tumors of the gastrointestinal tract, pancreas, liver, and retroperitoneal space (peritoneal carcinomatosis), liver, kidney, pancreas, bowel transplantations in children and adults, as well as the surgical treatment of obesity and general surgical interventions.
Department of Adult and Pediatric General, Abdominal, Hepatobiliary, Endocrine, Thoracic and Hernia Surgery
The Department of Adult and Pediatric General, Abdominal, Hepatobiliary, Endocrine, Thoracic and Hernia Surgery offers the full range of services in these fields. The team of the department's surgeons is rightfully proud of their high professionalism and successfully performs operations of varying degrees of complexity for diseases of the thyroid and parathyroid glands, stomach, esophagus, intestines, pancreas, liver, biliary tract, lungs. The medical facility also performs surgery for inguinal, umbilical and incisional hernias. The department has four high-tech operating rooms equipped with advanced surgical instruments, computer systems, devices for intraoperative ultrasound scanning, radiography, etc. Whenever possible, the department's surgeons perform low-traumatic laparoscopic procedures, after which patients need to spend only a few days in the hospital. The department has 100 beds for patient hospitalization.
Department of General, Abdominal and Pediatric Surgery
The Department of General, Abdominal and Pediatric Surgery offers the full range of surgical treatment of diseases of the organs of abdominal cavity, thorax, emergency surgical care in polytrauma, as well as many surgical interventions in children. Of particular interest is cancer surgery on the liver, gallbladder, and pancreas. In addition, the department's specialists masterfully manage all the methods of bariatric surgery. Many operations are performed using minimally invasive techniques, which facilitate the quickest possible recovery of the patient.
Department of General, Abdominal, Endocrine, Colorectal and Bariatric Surgery
According to the Focus magazine, the Department of General, Abdominal, Endocrine, Colorectal and Bariatric Surgery ranks among the top German departments specializing in colon cancer treatment! The department offers the full range of modern surgical interventions. The priority field of clinical activity is cancer surgery, in particular, sparing minimally invasive procedures and robot-assisted interventions. Each patient receives an individual therapy regimen, which is discussed at daily medical boards with doctors from other medical fields. In addition, the responsibility of the medical facility includes surgeries for endocrine disorders and bariatric interventions for morbid obesity. The team of the department's surgeons has a wealth of experience in classical open and minimally invasive procedures on the abdominal organs, as well as specializes in the innovative da Vinci robot-assisted surgery. The department also successfully performs cytoreductive interventions.
Department of General and Abdominal Surgery, Hernia Surgery, Endocrine, Hepatopancreatobiliary, Colorectal, Bariatric, Vascular and Pediatric Surgery
The Department of General and Abdominal Surgery, Hernia Surgery, Endocrine, Hepatopancreatobiliary, Colorectal, Bariatric, Vascular and Pediatric Surgery provides the full range of services in these medical fields. The highly qualified team of the department's surgeons specializes in performing operations of any degree of complexity in the treatment of pathologies of the liver, pancreas, gallbladder, and bile ducts, and diseases of the colon, rectum, and anus, as well as endocrine disorders. The department also performs all modern interventions for vascular pathologies, including aneurysms, carotid stenosis, and intermittent claudication. Patients with morbid obesity can undergo surgical treatment using the most modern and effective techniques. In addition, the medical facility employs experienced pediatric surgeons who provide surgical care to young patients. Operations are performed both on an inpatient and outpatient basis, in accordance with the best recommendations of professional societies. Doctors at the department's state-of-the-art operating rooms perform major interventions, navigation-guided surgery, and minimally invasive surgery to ensure fast recovery of patients.
Department of General and Abdominal Surgery, Hernia Surgery, Colorectal Surgery
According to the Focus magazine, the Department of General and Abdominal Surgery, Hernia Surgery, Colorectal Surgery ranks among the top German medical facilities specializing in the surgical treatment of gallbladder and biliary tract pathologies! The team of the department's surgeons admits patients with benign and malignant gastrointestinal diseases, namely stomach, liver, esophageal, gallbladder and biliary tract, pancreatic, colon and rectal pathologies. The department also carries out treatment for all types of hernias – the medical facility has a quality certificate from the German Hernia Society (DHG). Of particular interest is the resection of malignant tumors of the digestive system. The department's operating rooms have state-of-the-art medical equipment, therefore, in most cases, surgeons can perform interventions without extensive incisions in the skin and soft tissues, but with the use of minimally invasive techniques. Such an approach to surgical treatment greatly facilitates the patient's postoperative recovery process, reduces the risk of complications and excludes severe pain syndrome. The department's surgeons cooperate closely with gastroenterologists, hepatologists, oncologists, radiologists and other doctors from related medical fields. Doctors demonstrate high treatment success rates, use advanced surgical techniques, and observe hygiene and safety standards. Patients can be sure that their health is in the safe hands of leading European specialists.
Department of General and Abdominal Surgery, Hernia Surgery, Hepatopancreatobiliary Surgery, Colorectal Surgery, Thoracic Surgery, Endocrine Surgery and Bariatric Surgery
The Department of General and Abdominal Surgery, Hernia Surgery, Hepatopancreatobiliary Surgery, Colorectal Surgery, Thoracic Surgery, Endocrine Surgery and Bariatric Surgery offers a full range of surgical treatments for diseases of the intestine, stomach, esophagus, pancreas, liver, gallbladder, bile ducts, rectum, anus, thyroid gland, parathyroid glands, and adrenal glands. The department's surgeons are also skilled in inguinal, umbilical, femoral, and incisional hernia repair. An integral part of the department's daily clinical practice is the surgical treatment of diseases of organs in the chest: lung cancer, mediastinal tumors, chest wall tumors, pulmonary emphysema, myasthenia gravis, and pneumothorax. The medical facility also successfully performs bariatric surgery for morbid obesity. The department is part of the Robotic Surgery Center, which performs operations on the small intestine, rectum, stomach, and pancreas, as well as bariatric surgery using the innovative da Vinci robotic system. The department has been awarded the quality certificate by the German Cancer Society (DKG), which indicates outstanding success in the treatment of oncological diseases. Most surgical interventions are performed through a minimally invasive approach with minimal risks. The department's surgeons annually perform over 3,000 operations of varying complexity in inpatient and outpatient settings.
Colorectal (rectal) cancer is the widespread condition. Screening of the gastrointestinal tract pathologies is recommended for all people with symptoms of gastrointestinal tract disturbances.
Until now, rectal cancer treatment included resection of the intestine and chemotherapy if cancer has metastasized. Recently, endoscopic resection has been considered for patients with early stages of rectal cancer, as a minimally invasive rectal cancer treatment method.
Overview
As a rule, colorectal cancer develops as a result of malignant transformation of adenomatous polyps. Approximately 80% of colorectal cancer cases are sporadic, 20% of them develop due to the hereditary predisposition. Other risk factors include chronic ulcerative colitis and Crohn's disease. The risk of colorectal cancer also increases in people with unhealthy diets.
The risk of developing colorectal cancer is increased with insufficient intake of plant fiber, high intake of animal proteins, fats, and refined carbohydrates. Carcinogens may be found in food products, but are more likely to be synthesized by the gastrointestinal bacteria in response to intake of certain food substances. The exact mechanism for the synthesis of carcinogens is still unknown.
Colorectal cancer spreads by the direct growth of atypical cells into the intestinal wall, by hematogenous metastasizing and metastases spreading to regional lymph nodes.
Clinical signs
Colorectal cancer is characterized by slow growth. Thus, it takes quite a long time before the tumor reaches a large size and causes the first symptoms. Clinical manifestations depend on the location, type, and spreading of the tumor.
The right sections of the large intestine have a larger diameter and a thinner wall and contain liquids, so obstruction develops rarely. Latent blood loss is usually observed. The subjective symptoms may include general fatigue or severe anemia. Pain often appears with the spread of the rectal cancer process.
The descending colon has a smaller lumen, the feces there are watery. Therefore, colorectal cancer in this region tends to create an obstruction earlier than in the ascending colon. The first manifestations may be a partial obstruction with the appearance of colicky pains in the abdomen or complete obstruction.
In rectal cancer, the first symptom is usually a blood present in the feces. In any case, when blood is found in the feces, even with an established diagnosis of hemorrhoids, colorectal cancer diagnosis must be excluded. The feeling of incomplete emptying of the rectum may also be noted.
In some cases, the clinical manifestations such as the enlargement of the liver, ascites, and the lymphatic nodes may be the first signs of the tumor metastasizing.
Diagnostics
For patients from the moderate-risk group, screening for colorectal cancer should begin at the age of 50.
There are several screening options for rectal cancer, including:
- Colonoscopy. Colonoscopy remains the most informative method of diagnostics.
- Fecal occult blood test (fecal immunochemical tests are preferred). Fecal blood immunochemical tests are more sensitive and specific to human blood than other tests. However, both positive and negative test results do not confirm or exclude the possibility of rectal cancer.
- Sigmoidoscopy.
- CT colonography (virtual colonoscopy). CT colonography (virtual colonoscopy) allows doctors to obtain 2D and 3D images of the colon. High-resolution images are almost as informative as the endoscopic examination. CT colonography is a promising screening method in the presence of contraindications to endoscopy or refusal to perform it, but it has a lower sensitivity and precision. This test does not require anesthesia but requires careful bowel preparation. Additionally, unlike conventional colonoscopy, it is not possible to perform biopsy during the diagnostic procedure.
- Fecal DNA test.
When diagnosing colorectal cancer, abdominal CT scans, chest X-rays, and laboratory tests should be done to detect possible signs of the metastatic process, anemia, and to assess the patient's general health state.
Colorectal cancer removed during surgery is examined for gene mutations which cause Lynch syndrome. People who have relatives with colon, ovarian, or endometrial cancer diagnosed at an early age, or who have few relatives with these conditions, should be tested for Lynch syndrome as well.
Patients who have a first-degree relative with colorectal cancer diagnosed under the age 60 should undergo a colonoscopy every 5 years starting at age 40 or every 10 years after diagnosis of the relative. Screening of patients differs depending on the concomitant pathologies, if any are present.
Endoscopic resection
Early colorectal cancer is defined as cancer that is limited to the mucosa or submucosa. The detection of early colorectal cancer has been increasing, and some cases of early colorectal cancer can be treated with endoscopic mucosal resection.
Endoscopic resection is a minimally invasive method of surgical intervention with minimal risks of postoperative complications and recurrence of the tumor process. The method is based on the use of an endoscope, through which a loop electrode is inserted into the patient's large intestine, allowing to detect and remove malignant neoplasms.
Endoscopic resection is indicated for lesions of the mucosa or submucosa of the colon in which the risk of lymph node involvement is minimal.
Endoscopic mucosal resection is a less invasive alternative to the open surgery. The doctor may recommend the procedure to remove certain early-stage cancers or precancerous pathologies.
Endoscopic mucosal resection is used in the process of removing pathological neoplasms and is associated with risks, including a high probability of bleeding. Also, it is used to remove large or multiple rectal polyps.
Why are polyps important to treat?
A polyp is a mass that grows inside the lumen of the intestine. During the removal surgery, various processes inside the formation can be detected. This can be an ordinary thickening of the mucosa, edema, and inflammation in the mucosa in the form of a thickened fold, tumor-like growths of various tissues, submucosal formations such as lipoma, and, ultimately, it can be a cancerous tumor. Since various processes can develop inside this polyp, they must be studied during the histological examination, as a rule, performed before surgery.
The term "polyp" is used to define the pathological process of intestinal mucous tissues, which has a benign nature. The neoplasm itself does not pose a threat to the patient's life and health. However, there is a risk of transformation of polyps into a malignant tumor.
There are two types of endoscopic resection: endoscopic mucosal resection and endoscopic submucosal dissection.
Endoscopic submucosal dissection is a removal of a large area of the affected mucous membrane with a neoplasm and part of the submucosa with its muscle mass.
Gastrointestinal endoscopic mucosal resection is a procedure to remove early-stage cancer. Endoscopic mucosal resection can be used for both diagnosis and treatment.
For diagnostic purposes, endoscopic mucosal resection is used in single neoplasms. If histological examination becomes necessary, then large polyps with the suspicious structure are removed.
As for the treatment, small polyps are subject to endoscopic mucosal resection, but only if serious complications do not follow surgical manipulations. The method of endoscopic diagnostics and treatment is used when formations are superficial. If the formations are solitary or are located in groups, then the patient requires a surgery.
Endoscopic resection is a surgery prescribed when the volume of a polyp does not exceed 3 cm. Endoscopic resection allows removal with particular accuracy, due to optical equipment, displaying the resulting image on a computer. An endoscope is a device with probes and tips with optics and lighting. The endoscope has special passages for the introduction of surgical instruments. Endoscopic resection can be combined with conventional surgery or other types of rectal cancer treatment.
Treatment of malignant polyps with endoscopic resection does not worsen surgical and general clinical outcomes in cases of subsequent surgery. Mortality and morbidity of the procedure are low, so endoscopic resection generally is chosen in the presence of risk factors for residual cancer.
Endoscopic mucosal resection is performed with an endoscope equipped with a light and video camera. During endoscopic mucosal resection, the doctor passes the endoscope up through the anus to reach the colon. The doctor then inserts instruments through the tube to perform the procedure.
Endoscopic mucosal resection is very often used for rectal cancer treatment. However, the doctor may also harvest samples of tissue during the procedure. Examination of this tissue can help the doctors make a diagnosis. Endoscopic mucosal resection can help determine if cancer has spread to tissues beneath the digestive tract lining.
The optimal method for removing polyps in the intestine is selected individually, taking into account the characteristics of a particular clinical case. In general, endoscopic mucosal resection is a sparing method of removing benign neoplasms. After surgery, patients fully recover within one or two weeks. During the rehabilitation period after endoscopic mucosal resection, patients are recommended to follow a balanced diet to normalize the digestive process.
The endoscopic mucosal resection procedure also includes a pathological examination of the removed tissue. That is, after the completion of the surgical intervention, the biological material is sent to the laboratory to determine the presence of malignant transformation in the tissues.
Endoscopic mucosal resection of the colon and rectum is contraindicated in patients with poor blood clotting.
The price for treatment with endoscopic resection
The price for the treatment of rectal cancer in hospitals listed on the Booking Health website is relatively low. With Booking Health, you can undergo rectal cancer treatment in the best hospitals in the world at a lower cost.
The cost varies, as the price for treatment depends on the hospital, the diagnosis, and the complexity of treatment:
- The price for treatment in Germany is from 24,233 EUR to 37,612 EUR.
- The price for treatment in Israel is from 20,965 EUR to 21,288 EUR.
- The price for treatment in Turkey is from 11,888 EUR to 12,000 EUR.
The final cost may differ from the prices above. To make sure that the treatment is suitable for you, contact us by leaving the request on the Booking Health website.
Where can I undergo rectal cancer treatment abroad?
The best success rates in endoscopic resection are demonstrated by:
- Academic Hospital Brothers of Charity Munich, Germany
- University Hospital of Ludwig Maximilian University Munich, Germany
- Charite University Hospital, Germany
- University Hospital Ulm, Germany
- Tel Aviv Sourasky Medical Center, Israel
- Medipol Mega University Hospital Istanbul, Turkey
You can check out the full list of hospitals on the Booking Health website.
How can I undergo endoscopic resection in the best hospitals in the world?
It is not easy to choose the right hospital that performs endoscopic resection procedures. It is necessary to have experience and accurate information on the success rates in rectal cancer treatment in the particular hospital.
We may help you during this difficult period and take on all the troubles. Booking Health will select a hospital, taking into account your wishes and the indications for rectal cancer treatment.
We have up-to-date information on rectal cancer treatment in the best hospitals in the world. You can be free of unnecessary troubles, while Booking Health takes care of all organizational issues. Our goal is to find the best facility for rectal cancer treatment for you.
Rectal cancer can be treated! The earlier you start the treatment, the higher the chances of success. We will provide you with information on the hospitals, the cost of treatment, or any other.
Leave a request on the Booking Health website and our manager will contact you shortly.
