Personalized surgery for rectal tumours: the patient's opinion counts.
In recent times there have been many important changes in the surgical management of rectal cancer. The general thrust of these changes has been towards a less invasive approach with preservation of intestinal continuity and avoidance of the psychological sequelae of a stoma. It is also becoming increasingly apparent that profound sexual and autonomic dysfunction can be associated with abdominoperineal resection. This paper highlights these issues and the conflict between performing an adequate oncological procedure and reducing the incidence of postoperative psychological morbidity. It outlines the great changes there have been in surgical technique and their relevance to psychological problems after surgery for rectal cancer. The need for auditing psychological morbidity when assessing the outcome of surgical series is emphasised, as is the importance of involving the patient in the medical decision making.
Audisio
R A
RA
European Institute of Oncology (EIO), Milan, Italy.
Filiberti
A
A
Geraghty
J G
JG
Andreoni
B
B
D000005:Abdomen / Q000601:surgery; D001342:Autonomic Nervous System Diseases / Q000209:etiology; D003125:Colostomy / Q000523:psychology; D003657:Decision Making; D005260:Female; D006801:Humans; D008297:Male; D019060:Minimally Invasive Surgical Procedures; D010358:Patient Participation; D010502:Perineum / Q000601:surgery; D010817:Physician-Patient Relations; D011183:Postoperative Complications / Q000517:prevention & control / Q000523:psychology; D011788:Quality of Life; D012004:Rectal Neoplasms / Q000523:psychology / Q000601:surgery*; D012007:Rectum / Q000601:surgery; D012735:Sexual Dysfunction, Physiological / Q000209:etiology; D016896:Treatment Outcome