Objective: To summarize the recent literature on surgical treatment of locally recurrent rectal cancer (LRRC).
Background: LRRC is a heterogeneous disease that requires a multidisciplinary treatment approach. The treatment and prognosis depend on the site and type of recurrence. Radical resection remains the primary method for achieving long-term survival and improving symptom control. Preoperative chemoradiotherapy can reduce tumor volume and improve the R0 resection rate. Surgeons must clearly understand pelvic anatomy, develop a detailed preoperative plan, adopt a multidisciplinary approach for the surgical resection of the tumor as well as any invaded soft tissues, vessels, and bones, and ensure proper reconstruction. However, extended radical surgery often leads to a higher risk of postoperative complications and a low quality of life.
Methods: We searched English-language articles with keywords "locally recurrent rectal cancer", "surgery" and "multidisciplinary team" in PubMed published between January 2000 to October 2020.
Conclusions: LRRC is a complex problem. Long-term survival is not impossible following multidisciplinary treatment in appropriately selected LRRC patients. The management of LRRC relies on a specialist team that determines the biological behavior of the tumor and evaluates treatment options through multidisciplinary discussions, thereby balancing the surgical costs and benefits, alleviating postoperative complications, and improving patients' quality of life.
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http://dx.doi.org/10.21037/atm-21-2298 | DOI Listing |
Indian J Nucl Med
November 2024
Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India.
Objectives: The objective is to evaluate the efficacy of F-fluorodeoxyglucose positron emission tomography (F-FDG-PET) computed tomography (CT) in the evaluation of tumor response to preoperative/palliative chemoradiotherapy (CRT) for advanced colorectal cancer; including metastatic cancer at primary presentation and recurrent cancers with local and/or distant metastasis.
Materials And Methods: Fifty patients with advanced rectal cancer underwent two point imaging with 18 FDG PET-CT before and after 3 weeks of completion of preoperative/palliative CRT in between 2016 and 2022. Patients with locally recurrent cancer also underwent radical surgery.
Ann Surg Oncol
January 2025
Division of Colorectal Surgery, Changzheng Hospital, Navy Medical University, Shanghai, China.
Background: Local relapse has not been eradicated even in the era of total mesorectum excision. Although various approaches have been attempted, R0 resection remains the only potentially curative treatment. PATIENT AND METHODS: A 45-year-old woman with a history of laparoscopic abdominoperineal resection was diagnosed with pelvic recurrence 7 months ago.
View Article and Find Full Text PDFAnn Surg
January 2025
Surgical Outcomes Research Centre (SOuRCe), Royal Prince Alfred Hospital, Sydney, Australia.
Objective: To explore the perspectives and experiences of patients and carers living with the long-term consequences of pelvic exenteration.
Summary Background Data: Pelvic exenteration is accepted as the standard of care for selected patients with locally advanced or recurrent rectal cancer. With contemporary 5-year survival reported at 40-60%, the number of long-term survivors is expected to increase.
Colorectal Dis
January 2025
Department of Visceral Surgery, University Digestive Health Care Centre Basel-Clarunis, Basel, Switzerland.
Aim: Ventral mesh rectopexy (VMR) is an established surgical treatment for rectal prolapse and outlet obstruction. In contrast to continental Europe, in the UK and US the use of synthetic mesh has been abandoned in favour of biologic mesh, due to concerns regarding mesh related morbidity. The current study investigated if either material is superior, in terms of clinical recurrence and mesh related complications.
View Article and Find Full Text PDFUlus Travma Acil Cerrahi Derg
January 2025
Department of General Surgery, İstanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, İstanbul-Türkiye.
Background: This study evaluates the safety and effectiveness of coil embolization of the superior rectal artery for both emergency and elective treatment of rectal bleeding caused by Goligher grade 4 hemorrhoids, where surgery is contraindicated.
Methods: Between 2019 and 2024, 18 patients (11 males, 7 females) with a mean age of 65±10.3 years were included in the study.
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