[Surgical treatment of rectal cancer].
Rectal affection accounts for 30% of colorectal cancer. The standard of treatment is surgical resection, which often is curative. For superior and middle-rectal involvement, low anterior resection (LAR) is the preferred procedure. For tumors involving the lower portion of the rectum, abdominoperineal resection (APR) or LAR are the options of treatment, depending on sphincter involvement. The main surgical objective is to achieve a R0 resection with an appropriated total mesorrectal excision, greater number of lymph nodes and negative distal and radial margins. These surgical parameters have been used as quality indicators and have prognostic implications in terms of overall and disease-free survival. Total mesorectal excision with preservation of hypogastric nerves has shown a reduction in rates of sexual and bladder dysfunction as well as lower local recurrence. At specialized centers such procedures are performed by minimal invasive surgery; however the number of meta-analysis is scarce.
Departamento de Cirugía, Servicios de Cirugía Colorrectal y Cirugía Oncológica, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, México, D. F., Mexico. omarvergara74@hotmail.com
O
O
Vergara-Fernández
L E
LE
Salinas-Aragón
D
D
Camacho-Mauries
H
H
Medina-Franco
D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery*; D013505:Digestive System Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D018450:Disease Progression; D006801:Humans; D010535:Laparoscopy; D011183:Postoperative Complications / Q000453:epidemiology / Q000628:therapy; D011379:Prognosis; D012004:Rectal Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery*; D015996:Survival Rate; D016896:Treatment Outcome