Recurrent rectal or rectosigmoid cancer is a difficult therapeutic problem. A treatment program of external beam irradiation, surgery, and intraoperative irradiation has been used for 41 patients. The 5-year actuarial local control and disease-free survival of all 41 patients was 30% and 16%, respec
Planes of sharp pelvic dissection for primary, locally advanced, or recurrent rectal cancer
โ Scribed by Warren E. Enker; Nicole J. Kafka; Joseph Martz
- Publisher
- John Wiley and Sons
- Year
- 2000
- Tongue
- English
- Weight
- 507 KB
- Volume
- 18
- Category
- Article
- ISSN
- 8756-0437
No coin nor oath required. For personal study only.
โฆ Synopsis
In the design of operations for rectal cancers, the focus is often on circumventing the local extent of disease and leaving the pelvis free of cancer. The local extent of disease may range from minimal intramural invasion to the direct extension of a primary tumor to pelvic sidewall structures, e.g., the internal iliac vessels. In the absence of distant spread, understanding the planes of pelvic anatomy may allow the knowledgeable surgeon to cure patients who would otherwise be declared unresectable. We present the four planes (and one rare situation) available for sharp dissection which allow for the resection of all but a few cases of locally advanced disease.
๐ SIMILAR VOLUMES
Locally recurrent cancer of the rectum has been under-recognized as a complication, although it affects up to 40% of patients treated with surgery alone. Even in the best centers, rates average 25%. While radiotherapy may reduce recurrence, it is now apparent that total mesorectal excision is the mo