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Langenbeck's Archives of Surgery
Erschienen in: Langenbeck's Archives of Surgery 6/2021

02.08.2021 | State-of-the-Art Clinical Surgery

State-of-the-art surgery for recurrent and locally advanced rectal cancers

verfasst von: Mufaddal Kazi, Vivek Sukumar, Ashwin Desouza, Avanish Saklani

Erschienen in: Langenbeck's Archives of Surgery | Ausgabe 6/2021

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Abstract

Extended and beyond total mesorectal excisions (TME) for advanced and recurrent rectal cancers are increasingly performed with acceptable oncological and functional outcomes. These are undoubtedly due to better understanding of tumor biology and improved patient selection rather than surgical valor and technical refinements alone. In the present review, we attempt to present the current surgical standards for advanced and recurrent cancers requiring surgery outside the TME planes based on involved pelvic compartments. The available procedures, their indications, and extent of resection and reconstruction are highlighted. Emphasis is on formation of dedicated exenteration teams, structured training, and referral systems that increase hospital and surgeon volume to improve patient outcomes and reduce morbidity. Areas of deficiencies in literature were recognized with regards to factors influencing recurrences, patient selection, and quality of life. Finally, the most appropriate preoperative therapy for these tumors is unclear in both the primary and recurrent settings.
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Metadaten
Titel
State-of-the-art surgery for recurrent and locally advanced rectal cancers
verfasst von
Mufaddal Kazi
Vivek Sukumar
Ashwin Desouza
Avanish Saklani
Publikationsdatum
02.08.2021
Verlag
Springer Berlin Heidelberg
Erschienen in
Langenbeck's Archives of Surgery / Ausgabe 6/2021
Print ISSN: 1435-2443
Elektronische ISSN: 1435-2451
DOI
https://doi.org/10.1007/s00423-021-02285-8

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