Rectal Cancer

Despite lifestyle improvements, the incidence of rectal cancer is increasing in industrialised countries. Rapid advances in technology, growing knowledge of the biological history of the disease and closer attention to patients' quality of life after surgery have led to a less invasive approach. In the last 15 years, the surgical approach has shifted from extended resection to sphincter-saving procedures, featuring a multidiscipinary approach and a high level of specialisation. The experienced surgeon can plan and choose the "right treatment for the right patient" only with the support of the radiologist, endoscopist and pathologist (preoperative staging), oncologist and radiotherapist (neoadjuvant therapy), and psychologist and stomatherapist (rehabilitation). In addition, the difficult problems of salvage procedure and the reconstruction of anal sphincter after abdominal resection are explored.

"Despite lifestyle improvements, the incidence of rectal cancer is increasing in industrialised countries. Rapid advances in technology, growing knowledge of the biological history of the disease and closer attention to patients' quality of life after surgery have led to a less invasive approach. In the last 15 years, the surgical approach has shifted from extended resection to sphincter-saving procedures, featuring a multidisciplinary approach and a high level of specialisation. The experienced surgeon can plan and choose the "right treatment for the right patient" only with the support of the radiologist, endoscopist and pathologist (preoperative staging), oncologist and radiotherapist (neoadjuvant therapy), and psychologist and stomatherapist (rehabilitation). In addition, the difficult problems of salvage procedure and the reconstruction of anal sphincter after abdominal resection are explored.

Rectal Cancer. Epidemiology and Burden of Disease.- Diagnostic Imaging: Diagnosis and Staging.- Pre-Operative Staging: Endorectal Ultrasound.- Predictive Markers in Physiology and Anatomy for Outcomes in Rectal Cancer Patients.- Rectal Cancer: Pathological Features and their Relationship to Prognosis and Treatment.- TME: How to Interpret the Favourable Results?.- Lateral Pelvic Lymph Node Dissection (LPLD) in Rectal Cancer: an Overview.- Controversial Issues in Rectal Cancer Surgery.- Rectal Cancer and Quality of Life.- Mechanical Bowel Preparation (MBP) and Probiotic Administration Before Colorectal Surgery.- Indications for Local Excision in Rectal Cancer Surgery.- Local Excision of Rectal Cancer: TEM.- Low Anterior Resection.- Actuality of Colo-Anal Anastomosis.- Role of Colonic Reservoirs in Rectal Cancer Surgery.- Functional Results of Sphincter-Preserving Operations for Rectal Cancer.- Abdominoperineal Resection.- Laparoscopic and Robotic Surgery in Rectal Cancer.- Total Anorectal Reconstruction with an Artificial Bowel Sphincter.- Total Anorectal Reconstruction with Dynamic Graciloplasty.- Salvage Surgery After Recurrence.- Rectal Cancer and Inflammatory Bowel Disease.- Multimodality Therapy of Rectal Cancer.- Chemotherapy in Rectal Cancer.- Modern Aspects of Radiation Oncology for Rectal Cancer.- Surgical Therapy of Hepatic Metastases.- Chemotherapy for Metastatic Rectal Cancer.