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Related Concept Videos

Inflammatory Bowel Disease V: Surgical Management01:21

Inflammatory Bowel Disease V: Surgical Management

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Surgical interventions for inflammatory bowel disease (IBD), which includes ulcerative colitis and Crohn's disease, are essential in managing symptoms and addressing complications. The selection of surgical procedures is contingent upon the specific conditions and complications that stem from these illnesses.
Here are some common surgical interventions for IBD:
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Related Experiment Video

Updated: Jun 27, 2025

Robot-assisted Total Mesorectal Excision and Lateral Pelvic Lymph Node Dissection for Locally Advanced Middle-low Rectal Cancer
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Total Neoadjuvant Therapy for Rectal Cancer.

Arthur G Affleck1, Daniel Herzig2

  • 1Department of Surgery, Oregon Health and Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239, USA. Electronic address: https://twitter.com/AffleckIv.

The Surgical Clinics of North America
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PubMed
Summary
This summary is machine-generated.

The standard treatment for rectal cancer is evolving. Total neoadjuvant therapy, with chemotherapy before surgery, improves outcomes and may allow for omitting surgery in some patients.

Keywords:
Locally advanced rectal cancerOrgan preservationRectal cancerTotal neoadjuvant therapyWatch and wait

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Area of Science:

  • Oncology
  • Surgical Oncology
  • Gastroenterology

Background:

  • Multimodal therapy, including radiation, chemotherapy, and surgery, is the standard for locally advanced rectal cancer.
  • Treatment sequencing has evolved, with the German Rectal Cancer Trial approach (preoperative chemoradiation, surgery, adjuvant chemotherapy) being widely adopted.
  • Recent advances focus on optimizing systemic therapy delivery and patient selection.

Purpose of the Study:

  • To evaluate the impact of shifting chemotherapy to the preoperative setting in locally advanced rectal cancer.
  • To assess the benefits of total neoadjuvant therapy (TNT) on systemic control and survival.
  • To explore the potential for surgical omission in select patient groups undergoing TNT.

Main Methods:

  • Review of evolving treatment paradigms for locally advanced rectal cancer.
  • Analysis of outcomes associated with traditional neoadjuvant chemoradiation versus total neoadjuvant therapy.
  • Identification of patient subgroups potentially benefiting from TNT and surgical omission.

Main Results:

  • Total neoadjuvant therapy demonstrates superiority over traditional sequencing.
  • TNT offers improved systemic control and overall survival benefits.
  • TNT expands the possibility of omitting surgery in select rectal cancer patients.

Conclusions:

  • Total neoadjuvant therapy represents a significant advancement in rectal cancer treatment.
  • This approach enhances systemic treatment delivery and patient outcomes.
  • TNT broadens therapeutic options, including non-operative management for eligible patients.