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[Report on the workshop "workflow rectal cancer II" in Burghausen]
R Bittner1, J Burghardt, E Gross
1Arbeitsgruppe Workflow Rektumkarzinom II, Klinik für Allgemein- und Viszeralchirurgie, Marienhospital, Stuttgart.
Zentralblatt Fur Chirurgie
|May 23, 2007
Summary
This study outlines surgical techniques for lower rectal cancer, including total mesorectal excision and improved abdominalperineal resection. It also recommends a bidirectional approach with surgery and radiochemotherapy for rectal cancer with distant metastases.
Area of Science:
- Oncology
- Surgical Gastroenterology
- Colorectal Surgery
Background:
- The "workflow rectal cancer II" task force established operative standards for lower rectal cancer.
- Recent advancements address rectal cancer with primary distant metastases, necessitating updated treatment strategies.
Framework:
- Defines operative techniques: total mesorectal excision (TME) and improved abdominalperineal resection (APR).
- Introduces a bidirectional approach combining surgery and radiochemotherapy, where surgery is not always the primary intervention.
- Highlights the importance of reservoir creation in anastomoses below 6 cm from the anocutaneous verge for enhanced functional outcomes.
Implementation:
- Recommends the colon-j-pouch with a maximal loop length of 6 cm for anastomoses below 6 cm.
- Suggests further evaluation for alternative reservoir procedures in specific cases.
Implications:
- Optimizes surgical strategies for lower rectal cancer.
- Improves functional results for patients undergoing rectal cancer surgery.
- Provides a framework for managing rectal cancer with distant metastases through integrated treatment modalities.
