Rectal cancer is a major killer. Most of those dying after curative surgery suffer from recurrent disease in the pelvis. Local recurrence is also the only site of failure in up to 50% of patients. A disturbing fact is that the local recurrence rate shows considerably surgeon-related variances. There is now strong evidence that optimizing surgical technique by adopting the principle of total mesorectal excision (TME) will reduce local failure rate, increase the use of sphincter-saving operations, and improve functional results. Surgeons applying this surgical principle will consistently achieve similarly low recurrence rates.…mehr
Rectal cancer is a major killer. Most of those dying after curative surgery suffer from recurrent disease in the pelvis. Local recurrence is also the only site of failure in up to 50% of patients. A disturbing fact is that the local recurrence rate shows considerably surgeon-related variances. There is now strong evidence that optimizing surgical technique by adopting the principle of total mesorectal excision (TME) will reduce local failure rate, increase the use of sphincter-saving operations, and improve functional results. Surgeons applying this surgical principle will consistently achieve similarly low recurrence rates.
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Inhaltsangabe
Rectal Cancer - Natural History of the Disease.- 1 Cancer of the Rectum: Epidemiology, Improvement in Survival and the Role of a National Cancer Registry.- 2 Results of Rectal Cancer Treatment: A National Experience.- 3 Failure After Curative Surgery Alone.- Tumour Staging.- 4 Staging Systems - A Review.- 5 Limitations of Existing Systems of Staging for Rectal Cancer: The Forgotten Margin.- 6 Preoperative Staging: A Critical Analysis.- 7 Potential of Molecular Biology in Preoperative Evaluation.- The Anatomical Basis for Rectal Cancer Surgery.- 8 Rectal and Pelvic Anatomy with Emphasis on Anatomical Layers.- 9 Regional Anatomy of the Male Pelvic Nerve Plexus: Composition, Divisions and Relationship to the Lymphatics.- 10 Anatomical Basis of Total Mesorectal Excision and Preservation of the Pelvic Autonomic Nerves in the Treatment of Rectal Cancer.- Tumour Spread As a Basis for Rectal Cancer Surgery.- 11 Spread of Rectal Carcinomas.- 12 Importance of Lymphatic Spread.- 13 The Lymphatic Spread of Rectal Cancer and the Effect of Dissection: Japanese Contribution and Experience.- Surgical Technique - Options.- 14 Surgical Options in Rectal Cancer.- 15 Total Mesorectal Excision: History and Anatomy of an Operation.- 16 Total Mesorectal Excision with Pelvic Autonomic Nerve Preservation in the Operative Treatment of Rectal Carcinoma.- 17 Nerve-Sparing Surgery: Surgical Neuroanatomy and Techniques.- 18 Lateral Node Dissection - A Critique.- 19 Laparoscopic Approaches to Malignant Disease.- 20 Laparoscopic Resection of Rectal Cancer: Short and Long Term Results.- Reconstruction.- 21 Straight Colorectal and Coloanal Anastomosis.- 22 The Pelvic Pouch.- 23 Colonic J-Pouch or Straight Anastomosis in Low Anterior Resection for Rectal Carcinoma?.- 24 Role of a Protecting StomaAfter Rectal Resection for Cancer.- Outcome.- 25 Functional Results Following Rectal Surgery: A Review.- 26 The Effect of Specialization or Organization of Rectal Cancer Surgery.- 27 Surgery for Rectal Cancer: The Relationship Between Treatment Volume and Results.- The Role of Adjuvant Treatment if Surgery Is Optimal.- 28 Role of Radiotherapy in Addition to Optimal Surgery.- 29 Adjuvant Therapy for Rectal Cancers When Surgical Therapy Is Optimal.- 30 The Role of Adjuvant Treatment if Surgery Is Optimal: A Clinical Epidemiologist's View.- International Standardization and Research Strategies.- 31 International Standardization and Documentation of the Treatment of Rectal Cancer.
Rectal Cancer - Natural History of the Disease.- 1 Cancer of the Rectum: Epidemiology, Improvement in Survival and the Role of a National Cancer Registry.- 2 Results of Rectal Cancer Treatment: A National Experience.- 3 Failure After Curative Surgery Alone.- Tumour Staging.- 4 Staging Systems - A Review.- 5 Limitations of Existing Systems of Staging for Rectal Cancer: The Forgotten Margin.- 6 Preoperative Staging: A Critical Analysis.- 7 Potential of Molecular Biology in Preoperative Evaluation.- The Anatomical Basis for Rectal Cancer Surgery.- 8 Rectal and Pelvic Anatomy with Emphasis on Anatomical Layers.- 9 Regional Anatomy of the Male Pelvic Nerve Plexus: Composition, Divisions and Relationship to the Lymphatics.- 10 Anatomical Basis of Total Mesorectal Excision and Preservation of the Pelvic Autonomic Nerves in the Treatment of Rectal Cancer.- Tumour Spread As a Basis for Rectal Cancer Surgery.- 11 Spread of Rectal Carcinomas.- 12 Importance of Lymphatic Spread.- 13 The Lymphatic Spread of Rectal Cancer and the Effect of Dissection: Japanese Contribution and Experience.- Surgical Technique - Options.- 14 Surgical Options in Rectal Cancer.- 15 Total Mesorectal Excision: History and Anatomy of an Operation.- 16 Total Mesorectal Excision with Pelvic Autonomic Nerve Preservation in the Operative Treatment of Rectal Carcinoma.- 17 Nerve-Sparing Surgery: Surgical Neuroanatomy and Techniques.- 18 Lateral Node Dissection - A Critique.- 19 Laparoscopic Approaches to Malignant Disease.- 20 Laparoscopic Resection of Rectal Cancer: Short and Long Term Results.- Reconstruction.- 21 Straight Colorectal and Coloanal Anastomosis.- 22 The Pelvic Pouch.- 23 Colonic J-Pouch or Straight Anastomosis in Low Anterior Resection for Rectal Carcinoma?.- 24 Role of a Protecting StomaAfter Rectal Resection for Cancer.- Outcome.- 25 Functional Results Following Rectal Surgery: A Review.- 26 The Effect of Specialization or Organization of Rectal Cancer Surgery.- 27 Surgery for Rectal Cancer: The Relationship Between Treatment Volume and Results.- The Role of Adjuvant Treatment if Surgery Is Optimal.- 28 Role of Radiotherapy in Addition to Optimal Surgery.- 29 Adjuvant Therapy for Rectal Cancers When Surgical Therapy Is Optimal.- 30 The Role of Adjuvant Treatment if Surgery Is Optimal: A Clinical Epidemiologist's View.- International Standardization and Research Strategies.- 31 International Standardization and Documentation of the Treatment of Rectal Cancer.
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