Rectal cancer: surgical management

Abstract

Rectal cancer is defined as a tumor located between the anal verge and 15 cm within anal verge. In rectal cancer, a precise preoperative staging allows to categorize patients for different available treatments, as well as decide the best surgical treatment. The different treatment options that can be used in each case depend fundamentally on the extension of the tumor at the time of diagnosis. The main surgical objective is to achieve a resection with an a ppropriated total mesorectal scission, 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 scission with preservation of hypogastric nerves has shown a reduction in rates of sexual and bladder dysfunction as well as lower local recurrence.