Skip to main content

13.02.2019 | Surgery and Surgical Innovations in Colorectal Cancer (S Huerta, Section Editor) | Ausgabe 1/2019

Current Colorectal Cancer Reports 1/2019

Current Surgical Strategies in the Management of Rectal Cancer

Current Colorectal Cancer Reports > Ausgabe 1/2019
José Moreira de Azevedo, Bruna Borba Vailati, Guilherme Pagin São Julião, Laura Melina Fernandez, Rodrigo Oliva Perez
Wichtige Hinweise
This article is part of the Topical Collection on Surgery and Surgical Innovations in Colorectal Cancer

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.


Purpose of Review

The surgical approach to rectal cancer has become significantly more complex with the introduction of neoadjuvant therapies and organ preservation strategies. Optimal radiological imaging in association with relevant clinical findings provides critical information for final surgical management decision. The present review focuses on the surgical alternatives available in different clinical scenarios for the management of rectal cancer.

Recent Findings

Most of evidence for surgical management of rectal cancer is provided by non-randomized studies. However, a few randomized clinical trials have attempted to address the optimal surgical approach for total mesorectal excision. In addition, recent randomized trials have also contributed to the understanding of the role of organ-preserving strategies among patients with excellent response to neoadjuvant treatment. Finally, one randomized Japanese study has provided oncological evidence in favor of prophylactic lateral node dissection among these patients.


Radical proctectomy with total or partial mesorectal excision is the standard procedure for most patients with primary rectal cancer. Optimal approach for this procedure remains controversial. The decision between sphincter-preservation strategies and abdominal perineal resections should take into account the radiological and clinical findings. More recently, organ-preserving strategies including transanal local excisions may be used in select patients with early-stage disease or among patients undergoing neoadjuvant treatment strategies after significant primary tumor regression. Extended procedures including lateral pelvic side lymphadenectomies and exenterative procedures should be done selectively and in highly specialized centers.

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

e.Med Interdisziplinär

Mit e.Med Interdisziplinär erhalten Sie Zugang zu allen CME-Fortbildungen und Fachzeitschriften auf Zusätzlich können Sie eine Zeitschrift Ihrer Wahl in gedruckter Form beziehen – ohne Aufpreis.

Jetzt e.Med bestellen und 100 € sparen!

Weitere Produktempfehlungen anzeigen
Über diesen Artikel

Weitere Artikel der Ausgabe 1/2019

Current Colorectal Cancer Reports 1/2019 Zur Ausgabe

Surgery and Surgical Innovations in Colorectal Cancer (S Huerta, Section Editor)

Techniques for Colorectal Anastomotic Construction Following Proctectomy and Variables Influencing Anastomotic Leak

Systemic Therapies in Colorectal Cancer (SM Kazmi, Section Editor)

Current Status of Maintenance Systemic Therapies in Metastatic Colorectal Cancer: 2018 Update

Surgery and Surgical Innovations in Colorectal Cancer (S Huerta, Section Editor)

A Surgeon’s Guide to Treating Older Patients With Colorectal Cancer

  1. Sie können e.Med Innere Medizin 14 Tage kostenlos testen (keine Print-Zeitschrift enthalten). Der Test läuft automatisch und formlos aus. Es kann nur einmal getestet werden.

  2. Das kostenlose Testabonnement läuft nach 14 Tagen automatisch und formlos aus. Dieses Abonnement kann nur einmal getestet werden.

Neu im Fachgebiet Onkologie

Mail Icon II Newsletter

Bestellen Sie unseren kostenlosen Newsletter Update Onkologie und bleiben Sie gut informiert – ganz bequem per eMail.