Multivisceral Resection in Rectal Cancer

摘要: The treatment of locally advanced rectal cancer (T3/4 or N1/2) is challenging and requires a multidisciplinary approach including diagnostic radiology, medical oncology, pathology, radiation therapy, surgery. Unlike many solid tumors, invasive not necessarily unresectable (Lopez 2001). Indeed, over the past 30 years, it has been shown that significant percentage even large colorectal tumors remain localized do metastasize; therefore, en-bloc resection with clear margins can lead to cure 2001; Gebhardt et al. 1999, Nakafusa 2004; Lehnert 2002; Klaassen Govindarajan 2006). In study by Spratt Spjut involving examination more than 1,000 two-thirds had reportedly metastasized locoregional lymph nodes (Spratt 1970). However, up 15% adhere invade adjacent pelvic organs. Since surgeon cannot easily distinguish malignant fistula from an inflammatory adhesion (Gebhardt 1999), because separation local tumor dissemination recurrence, multivisceral should be considered. Advanced planning, strict adherence principles surgical necessary when treating these difficult cases.y 1999; important recognize will adherent into differentiate cases.