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Rectal cancer is one of the most frequently diagnosed malignancies, associated with high morbidity and mortality, which justify the constant interest in fine-tuning the available therapeutic methods and developing new ones. The preference for one surgical technique over another is highly dependent on the stage, the location of the tumor, other patient-related factors and the experience of the surgical team. This article aims to offer a comprehensive review of the surgical modalities utilized at the present time for the curative treatment of rectal cancer, as well as the future directions in this field, pointing out the latest progress and the most recent shifts in paradigm in the management of rectal cancer.
View Article and Find Full Text PDFArtificial intelligence-based model to predict recurrence after local excision in T1 rectal cancer.
Eur J Surg Oncol
February 2025
Department of Gastrointestinal Surgery, Department of General Surgery, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, 510000, China. Electronic address:
Background: According to current guideline, patients with resected specimens showing high-risk features are recommended additional surgery after local excision (LE) of T1 colorectal cancer, despite the low incidence of recurrence. However, surgical resection in patients with low rectal cancer (RC) is challenging and may compromise anal function, leading to a low quality of life. To reduce unnecessary surgical resection in these patients, we used artificial intelligence (AI) to develop and validate a prediction model for the risk of recurrence after LE.
View Article and Find Full Text PDFFluorescence-guided mesorectal nodes harvesting associated with local excision for early rectal cancer: technical notes.
Minim Invasive Ther Allied Technol
March 2025
ASST Cremona - UOC General Surgery, Cremona, Italy.
Background: The spread of colorectal cancer screening has increased the percentage of patients with early-stage rectal cancer; at least 30% of patients are diagnosed with a clinical-stage cT1 or pT1 after endoscopic excision. In this subgroup of patients, the real advantage of total mesorectal excision (TME) over local excision (LE) is the ability to remove mesorectal nodes, which are metastatic in less than 20% of cases.
Method: To solve the unmet need for accurate nodal staging in patients with cT0/cT1, cN0 rectal cancer, we designed a pilot study that associates LE with mesorectal fluorescence-guided nodal sampling.
Urethral Visualization Using Near-infrared Light Observation During Transanal/Perineal Total Mesorectal Excision.
Anticancer Res
March 2025
Department of Digestive Surgery, Kawaguchi Municipal Medical Center, Kawaguchi, Japan.
Background/aim: Transanal total mesorectal excision is a useful technique while performing lower rectal cancer and deep pelvic surgery. However, it is a relatively difficult procedure, and unique complications such as urethral injury have been reported. Although there have been a few reports on urethral visualization, we investigated whether it is possible to visualize the urethra using a fluorescent urethral catheter.
View Article and Find Full Text PDFOncologic Relevance and Anal Preservation Potential of Transanal Total Mesorectal Excision for Rectal Cancer Invading Adjacent Organs.
Anticancer Res
March 2025
Department of Gastroenterological Surgery, NHO Kyushu Cancer Center, Fukuoka, Japan.
Background/aim: Locally advanced rectal cancer (LARC) with adjacent organ invasion presents significant surgical challenges, particularly in achieving negative circumferential resection margins (CRM). Transanal total mesorectal excision (TaTME) offers improved visualization and dissection in the deep pelvis, potentially enhancing oncologic and functional outcomes. This study evaluates the feasibility, oncologic safety and the possibility of anal preservation of TaTME in cT4b rectal cancer requiring combined organ resection.
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