Abstract
A review of advancement of rectal cancer surgery in Japan is presented. The standard operation for rectal cancer was altered in the 1960s from abdominoperineal resection to the pull-through technique and the handsewn anterior resection in the 1970s, and it became the stapled anterior resection in the 1980s. Today, more than 75 percent of rectal cancers are treated with sphincter-preserving anterior resections, and the remaining 20 percent by abdominoperineal resections. Colonic J-pouch is used with anastomoses involving very low anterior rectal resection for cancers. In the late 1970s, a method of dissecting extended pelvic nodes was adopted to decrease local recurrence. However, extended dissection has been applied to only T3 and T4 cancers of the lower rectum because of postoperative dysfunction of pelvic organs. This was caused by injury to the pelvic nerve plexus, thus lowering the quality of life of the patients. Since the middle of the 1980s, the autonomic nerve-preserving operation attracted surgeons' attention because it prevented these dysfunctions from occurring as a result of the treatment of cancer in the upper rectum and for T1 or T2 cancers in the lower rectum. In this article, recent advances in rectal cancer surgery in Japan are reviewed.
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References
Statistics and Information Department, Minister's Secretariat, Ministry of Health and Welfare. Vital Statistics of Japan 1994;3:96–109.
Japanese Society for Colon and Rectum and Anus. General rules for clinical and pathological studies on cancer of colon, rectum and anus. Jpn J Surg 1983;13:557–73.
Kuru M. Rectal cancer. Jpn J Surg 1941;41:832–77.
Kuru M. Rectal cancer. Igaku 1951;11:326–38.
Jinnai D, Ono M, Niguma M,et al. Sphincter-preserving operation for rectal cancer. Geka Chiryo 1961;4:163–78.
Jinnai D, Yasutomi M. Cancer of the colon and rectum. GANN Monograph on Cancer Reserch 1979;22:89–99.
Goligher JC, Duthie HL, Dedombal FT,et al. Abdominoanal pull-through excison for tumors of the mid-third of the rectum. Br J Surg 1965;52:323–35.
Yasutomi M, Fukuhara T, Izumoto G. Postoperative evaluation of fecal continence after sphincter-preserving operations for rectal cancer. Jpn J Surg 1982;12:337–43.
Yasutmomi M, Fukuhara T, Matsuda T. Colon-anal anastomosis by stapling suture instruments using the invagination technique. Coloproctology 1983;83:75–80.
Konn M. Low anterior resection for rectal cancer. Geka Chiryo 1979;41:13–21.
Goligher JC. Use of circular stapling gun with peranal insertion of anorectal purse-string suture for construction of very low colorectal or colo-anal anastomosis. Br J Surg 1979;66:501–4.
Nicholls RJ, Lubowski DZ, Donaldson DR. Comparison of colonic reservoir and straight colo-anal reconstruction after rectal excision. Br J Surg 1988;75:318–20.
Kusunoki M, Shoji Y, Yanagi H,et al. Function after anoabdominal rectal resection and colonic J pouch-anal anastomosis. Br J Surg 1991;78:1434–8.
Hida J, Yasutomi M, Fujimoto K,et al. Functional outcome after low anterior resection with low anastomosis for rectal cancer using the colonic J-pouch: prospective randomized study for determination of optinum pouch size. Dis Colon Rectum 1996;39:986–91.
Koyama Y. Extended dissection for rectal cancer. Geka Chiryo 1977;6:41–5.
Takahashi T, Kajitani T. Lateral spread of cancer and meaning of lateral pelvic nodes dissection in rectal cancer surgery. J Jpn Soc Colo-proctol 1978;31:207–19.
Hojo K, Koyama Y. The effectiveness of wide anatomical resection and radical lymphadenectomy for patients with rectal cancer. Jpn J Surg 1982;12:111–6.
Moriya Y, Hojo K, Sawada T, Koyama Y. Significance of lateral node dissection for advanced rectal carcinoma at or below the peritoneal reflection. Dis Colon Rectum 1989;32:307–15.
Yasutomi M. Rectal cancer surgery in Japan. Hokkaido University Medical Series 1994;35:151–9.
Fowler JW. Bladder functions following abdominoperineal excision of the rectum for carcinoma. Br J Surg 1973;60:574–6.
Aso R, Yasutomi M. Urinary and sexual disturbances following radical surgery for rectal cancer. Am J Proctol 1974;6:56–67.
Sato K, Sato T. The vascular and neuronal composition of the lateral ligament of the rectum and the rectosacral fascia. Surg Radiol Anat 1991;13:17–22.
Hojo K. Preservation of micturitional and sexual functions in the surgery for rectal cancer. Igaku no ayumi 1981;119:716–23.
Tsuchiya S. Autonomic nerve preservation in rectal cancer surgery. Surgery 1982;44:1367–73.
Hojo K, Sawada T, Moriya Y. An analysis of survival and voiding, sexual function after wide iliopelvic lymphadenectomy in patients with carcinoma of the rectum, compared with conventional lymphadenectomy. Dis Colon Rectum 1989;32:128–33.
Sugihara K, Moriya Y, Akasu T,et al. Pelvic autonomic nerve preservation for patients with rectal carcinoma. Cancer 1996;78:1871–80.
Moriya Y, Sugihara K, Akasu T,et al. Nerve-sparing surgery with lateral node dissection for adcance lower rectal cancer. Eur J Cancer 1995;31:1229–32.
Masui H, Ike H, Yamaguchi S,et al. Male sexual function after autonomic nerve-preserving operation for rectal cancer. Dis Colon Rectum 1996;39:1140–5.
Japanese Society for Cancer of the Colon and Rectum. A multi-institutional registry of large bowel cancer in Japan. Vol. 12. Tochigi: Registry Committee of JSCCR, 1996.
Takagi H, Morimoto T, Kato T,et al. Pelvic exenteration combined with sacral resection for recurrent rectal cancer. J Surg Oncol 1983;24:161–6.
Koyama Y. Total pelvic exenteration. Shokaki geka 1983;6:998–1007.
Japanese Society for Cancer of Colon and Rectum. A registry of total pelvic exenteration in Japan. Osaka: Japnese Society for Cancer of Colon and Rectum, 1994.
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Yasutomi, M. Advances in rectal cancer surgery in Japan. Dis Colon Rectum 40 (Suppl 10), S74–S79 (1997). https://doi.org/10.1007/BF02062025
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DOI: https://doi.org/10.1007/BF02062025