Abdominoperineal Resection
Fig. 11.1 (a) Plane of resection utilized when TME plane is followed to its termination. A waist is produced at the level of the puborectalis. (b) Plane of resection when…
Local Excision of Rectal Cancer
High risk Low risk Poor differentiation Well and moderate differentiation Size ≥3 cm Size <3 cm Circumferential involvement ≥30 % of lumen Circumferential involvement <30 % of lumen Presence of…
Anatomy and Physiology of the Rectum and Anus
Fig. 3.1 Embryonal development of the cloaca (Reproduced from Schunke M, et al. Promethius LernAtlas der Anatomie, vol. 2. 3rd ed. Stuttgart: Thieme Publ.; 2012, with permission) At this point…
Abdominosacral Resection for Rectal Cancer
Fig. 10.1 T2 weighted MRI showing invasion of tumor posteriorly into the sacrum. The arrow shows tumor invasion within the posterior compartment Despite all the recent developments in surgery and…
Rectal Cancer Treatment in the Elderly
Fig. 25.1 Physiological function and functional reserve. (a) The natural decline of organ function (physiological function), basic physiologic needs and functional reserve. (b) The influence of co-morbidity on organ function…
Palliative Options in Patients with Stage 4 Rectal Cancer
Contraindications to R0 Resection Tumors involving the sciatic nerve Tumors encasing the common and/or external iliac arteries Tumors obstructing the bilateral ureters Tumors causing extensive fixation to the lateral pelvic…
Pathology and Staging of Rectal Cancer
Fig. 4.1 Transanal excision of early-stage rectal adenocarcinoma. (a) A single piece of transanal excision specimen with a suture denoting the proximal end. (b) Section shows a well-differentiated adenocarcinoma invades…
Remedial Surgery Following Failed Colorectal or Coloanal Anastomosis
Fig. 28.1 Colorectal anastomosis with transmesenteric passage of the transverse colon and closure of the peritoneal defect This procedure was first described in 1961 by André Toupet [17, 18]. At…
Quality Assurance in Rectal Cancer Management
Tools to improve cancer care Strengths Weaknesses Randomised trials Proof of treatment effects Selection bias, high costs, time-consuming, confounding factors Evidence based guidelines/ consensus Create awareness, focus on key treatments…
Less Common Rectal Tumors
Diameter (cm) Metastatic potential (%) <1.0 3–5 1.0–1.9 10–30 ≥2.0 >75 Adapted from Koura et al. [12], Grossmann et al. [219] The majority of diagnosed rectal carcinoids (65–80 %) will…
