Organ Preservation in Rectal Cancer Management by Dr Deep Goyal – Insights from WALS 2025 Conference скачать в хорошем качестве

Organ Preservation in Rectal Cancer Management by Dr Deep Goyal – Insights from WALS 2025 Conference

The 8th World Congress of Laparoscopic Surgeons (WALS 2025) served as a platform for global leaders in minimally invasive surgery to discuss groundbreaking advancements in surgical oncology. Among the most anticipated sessions was a thought-provoking presentation by Dr. Deep Goyal on “Organ Preservation in Rectal Cancer Management.” His talk focused on the latest strategies to optimize oncological outcomes while preserving rectal function, reducing morbidity, and improving the quality of life for patients. The Evolution of Rectal Cancer Treatment Historically, total mesorectal excision (TME) has been the gold standard for rectal cancer treatment. However, this approach, despite its oncological efficacy, often leads to permanent colostomy, significant bowel dysfunction, and compromised quality of life. Over the past decade, the paradigm has shifted towards organ preservation through non-operative management strategies, particularly for patients achieving complete clinical response (cCR) after neoadjuvant therapy. Key Takeaways from Dr. Deep Goyal’s Presentation 1. Neoadjuvant Therapy and Watch-and-Wait Approach • Dr. Goyal emphasized the growing role of total neoadjuvant therapy (TNT), combining chemotherapy and radiation to achieve tumor downstaging. • Patients achieving a complete clinical response (cCR) can be considered for a watch-and-wait approach, avoiding radical surgery. • He cited evidence from ongoing clinical trials demonstrating comparable oncological outcomes between watch-and-wait and surgical intervention in select cases. 2. Minimally Invasive Surgical Techniques • Transanal Endoscopic Microsurgery (TEM) and Transanal Minimally Invasive Surgery (TAMIS) were highlighted as promising techniques for local excision in carefully selected early-stage tumors. • These approaches offer better functional outcomes while maintaining oncological safety. 3. Role of Biomarkers and Imaging in Patient Selection • Advanced imaging techniques, including MRI-based tumor regression grading and PET-CT, help identify patients who are candidates for non-operative management. • The use of molecular and genetic biomarkers was discussed as a future avenue for individualized treatment strategies. 4. Challenges and Future Directions • Dr. Goyal acknowledged the challenges of implementing organ preservation protocols, particularly the risk of local recurrence and the need for strict surveillance. • He emphasized the importance of multidisciplinary team (MDT) discussions involving surgeons, oncologists, and radiologists to ensure optimal patient selection and monitoring. Conclusion Dr. Deep Goyal’s presentation at WALS 2025 reinforced the transformative potential of organ-preserving strategies in rectal cancer management. As evidence continues to evolve, personalized treatment approaches integrating neoadjuvant therapy, local excision, and active surveillance will redefine the standard of care for rectal cancer patients. The laparoscopic and robotic surgical community remains at the forefront of refining these techniques, ensuring that oncological safety and quality of life go hand in hand. This session served as a testament to the ongoing advancements in minimally invasive cancer surgery, aligning with the broader mission of WALS 2025—to drive innovation in minimal access surgery for better patient outcomes.