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Advances in surgical treatment of rectal cancer.

Authors
  • Rullier, E1
  • Laurent, C
  • 1 Service of Digestive Surgery, Saint-André Hospital, Bordeaux, France. [email protected]
Type
Published Article
Journal
Minerva chirurgica
Publication Date
August 2003
Volume
58
Issue
4
Pages
459–457
Identifiers
PMID: 14603158
Source
Medline
License
Unknown

Abstract

Autonomic pelvic nerves are preserved by the technique of total mesorectal excision (TME) and adapted anterior dissection plans improve preservation of genito-urinary functions. Sphincter preservation can be achieved by a conventional anterior resection for high and mid-rectal tumours, and by the technique of intersphincteric resection for low tumours. A J-pouch or a recently-designed coloplasty pouch must be associated with coloanal anastomoses in order to improve functional results and loop ileostomy is recommended to decrease early postoperative morbidity. Local excision constitutes an alternative to major surgery in patients with a low-risk early rectal cancer. Neoadjuvant treatments have a role in local control of the disease after TME surgery and in new strategies of sphincter-saving procedures. The place of anorectal reconstruction and that of laparoscopy are also discussed.

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