How low is low? Evolving approaches to sphincter-sparing resection techniques. Semin Radiat Oncol 2011 Jul;21(3):185-95
Date
06/08/2011Pubmed ID
21645863DOI
10.1016/j.semradonc.2011.02.004Scopus ID
2-s2.0-79957984225 (requires institutional sign-in at Scopus site) 3 CitationsAbstract
Although advances in rectal cancer staging may ultimately be accurate enough to reliably exclude disease outside the rectal wall (thereby allowing local approaches to be more widely and safely applied) and advances in the use of neoadjuvant chemo- and radiation therapy may ultimately produce more "complete responders" that can be accurately identified and spared surgery altogether, as it stands, radical resection forms the basis of curative treatment for rectal cancer. However, the concepts that guide the surgeon in choosing the optimal approach in radical resection are changing. In the past, the decision as to how to proceed surgically with radical resection was based primarily on the level of the tumor above the anal verge or anorectal ring. The issue was primarily "How low is the tumor?" and "Is the distal margin safe?" A more modern approach focuses attention on achieving a negative circumferential margin despite what historically may seem to be a very minimal distal margin, the current issue is not "How low is the tumor?" so much as it is "How deep does the tumor go?". This shift in focus has been a major impetus in the evolution of sphincter sparing resection techniques.
Author List
Ludwig K, Kosinski LAuthor
Kirk A. Ludwig MD Chief, Professor in the Surgery department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
Anal CanalAnastomosis, Surgical
Decision Making
Digestive System Surgical Procedures
Humans
Neoplasm Recurrence, Local
Neoplasm Staging
Neoplasm, Residual
Quality of Life
Rectal Neoplasms
Risk Factors
