[Historical review and contemporary trends in the surgical treatment of the rectal cancer].
A historical review of the surgical treatment of rectal cancer is done. Along with the increasing knowledge about the intramural cancer spreading in distal direction, the indications for sphincter-preserving operations expand. In practice, the ablasticity of the surgical intervention in 90% is assured by resection line at 2 cm from the distal margin of the macroscopic tumor. It is underlined the importance of the mesorectal excision for decreasing the local recidives rate. According to review of the available scientific data and to the personal experience during the last 10 years, the author recommends sphincter-saving procedures by localization of highly and moderately differentiated tumors at 1, 5-2cm above dentate line. Since long it has been preferred the straight manual transanal termino-terminal coloanal anastomosis or the latero-terminal coloanal anastomosis with 5-6cm long J pouch. This type of surgical interventions is highly attractive because of the opportunity to preserve the sphincter apparatus, which is of a great importance for the good life quality of the patients. The eventual later local recurrence could be easily diagnosed and treated by abdominoperineal extirpation and total pelvic exenteration.
Damianov
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D000714:Anastomosis, Surgical / Q000379:methods / Q000639:trends; D013505:Digestive System Surgical Procedures / Q000379:methods / Q000639:trends; D006801:Humans; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology / Q000601:surgery*; D012004:Rectal Neoplasms / Q000453:epidemiology / Q000601:surgery*