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Evolution of Surgical Treatment for Rectal Cancer: a Review

  • Review Article
  • Published:
Journal of Gastrointestinal Surgery Aims and scope

Abstract

Surgery that produces an optimal total mesorectal excision (TME) resection specimen remains the cornerstone of curative rectal cancer management. In the modern era, despite the results of recent randomised trials, laparoscopic TME is a crucial technique in the TME surgery armamentarium. Laparoscopic surgery offers the benefit of magnified views that aid sharp and precise dissection. However operating in the confines of a narrow pelvis, particularly when the mesorectum is bulky, requires significant technical skill. This is compounded by limited angulation of laparoscopic instruments and staplers. The final challenge is to preserve the integrity of the mesorectum during delivery of the specimen. The principles of TME surgery, on which Bill Heald founded the Basingstoke Colorectal unit, can equally be applied to laparoscopic, transanal and robotic TME, but great care must be taken to preserve the key principle—that no steps are taken that have the potential to shed tumour cells or compromise the quality of the mesorectal specimen.

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  1. Department of Surgery & Peritoneal malignancy Institute, Basingstoke and North Hampshire Hospital, Basingstoke, RG24 9NA, UK

    Sanjeev Dayal, Nick Battersby & Tom Cecil

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Dayal, S., Battersby, N. & Cecil, T. Evolution of Surgical Treatment for Rectal Cancer: a Review. J Gastrointest Surg 21, 1166–1173 (2017). https://doi.org/10.1007/s11605-017-3427-9

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