Related Experiment Videos
Local excision of rectal cancer
1Division of Colon and Rectal Surgery, Beth Israel-Deaconess Medical Center, Harvard Medical School, 110 Francis Street, Suite 3A, Boston, Massachusetts 02215, USA.
World Journal of Surgery
|September 1, 1997
Summary
Local excision offers a less morbid alternative for rectal cancer treatment compared to radical resection. This technique provides excellent cure rates for select patients, avoiding the need for a permanent colostomy.
Area of Science:
- Surgical Oncology
- Gastroenterology
Background:
- Rectal cancer treatment often induces fear of permanent colostomy.
- Radical resection, like abdominoperineal resection, is effective but highly morbid.
- Local excision presents a less invasive alternative with high cure rates.
Purpose of the Study:
- To evaluate local excision as a treatment for early-stage rectal cancer.
- To identify selection criteria for appropriate patients undergoing local excision.
- To compare the morbidity of local excision with radical resection.
Main Methods:
- Review of local excision techniques for small rectal cancers (diameter <4 cm, <40% circumference).
- Preoperative staging using endorectal ultrasonography, CT, and digital examination.
- Analysis of retrospective and prospective series data on local recurrence rates.
Main Results:
- Local excision is suitable for well-selected patients with early-stage rectal cancer.
- Local recurrence rates range from 0% to 11% in retrospective and prospective studies.
- Local excision offers significantly less morbidity than abdominoperineal resection.
Conclusions:
- Local excision is a viable, less morbid treatment option for selected rectal cancer patients.
- It avoids the need for permanent colostomy associated with radical resection.
- Future studies should adequately document postoperative function and quality of life.