Advances in surgical management for locally recurrent rectal cancer: How far have we come?
Locally recurrent rectal cancer(LRRC) is a complex disease with far-reaching implications for the patient. Until recently, research was limited regarding surgical techniques that can increase the ability to perform an en bloc resection with negative margins. This has changed in recent years and ther...
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Published in | World journal of gastroenterology : WJG Vol. 23; no. 23; pp. 4170 - 4180 |
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Main Authors | , , , |
Format | Journal Article |
Language | English |
Published |
United States
Baishideng Publishing Group Inc
21.06.2017
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Subjects | |
Online Access | Get full text |
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Summary: | Locally recurrent rectal cancer(LRRC) is a complex disease with far-reaching implications for the patient. Until recently, research was limited regarding surgical techniques that can increase the ability to perform an en bloc resection with negative margins. This has changed in recent years and therefore outcomes for these patients have improved. Novel radical techniques and adjuncts allow for more radical resections thereby improving the chance of negative resection margins and outcomes. In the past contraindications to surgery included anterior involvement of the pubic bone, sacral invasions above the level of S2/S3 and lateral pelvic wall involvement. However, current data suggests that previously unresectable cases may now be feasible with novel techniques, surgical approaches and reconstructive surgery. The publications to date have only reported small patient pools with the research conducted by highly specialised units. Moreover, the short and long-term oncological outcomes are currently under review. Therefore although surgical options for LRRC have expanded significantly, one should balance the treatment choices available against the morbidity associated with the procedure and select the right patient for it. |
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Bibliography: | Daniel Jin-Keat Lee;Peter M Sagar;Gaitri Sadadcharam;Kok-Yang Tan;Department of Surgery, Khoo Teck Puat Hospital;John Goligher Colorectal Surgery Unit, St James’s University Hospital ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-3 content type line 23 ObjectType-Review-1 Telephone: +65-6602-2207 Fax: +65-6602-3648 Author contributions: Lee DJK performed the majority of the research around this topic, wrote the manuscript and obtained figures for the article; Sagar PM and Tan KY designed the article framework and contributed to the editing of the manuscript; Sadadcharam G contributed to the editing of the article as well as some of the writing. Correspondence to: Dr. Kok-Yang Tan, Associate Professor, Head and Senior Consultant, Department of Surgery, Khoo Teck Puat Hospital, 90 Yishun Central, Singapore 768828, Singapore. tan.kok.yang@alexandrahealth.com.sg |
ISSN: | 1007-9327 2219-2840 |
DOI: | 10.3748/wjg.v23.i23.4170 |