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2017, Number 1

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Revista Cubana de Cirugía 2017; 56 (1)

From abdominoperineal resection to conservative techniques of interest in relation to laparoscopic surgery for rectal cancer

Barreras GJE, Barreras SEJ, Cáceres LHH

Language: Spanish
References: 44
Page: 37-49
PDF size: 81.91 Kb.


ABSTRACT

Introduction: the main rule for the management of rectal cancer is oncologic cure and the maintenance of quality of life. The advent of laparoscopic surgery has had an impact on gastrointestinal surgery over the last 20 years. Three decades following its original description by Heald, total mesorectal excision has become the gold standard for the curative resection of rectal cancer.
Objectives: To review the different technical options currently available for the laparoscopic treatment of rectal cancer, by describing their outcomes, advantages and disadvantages.
Methods: A review was performed in the bibliographical databases accessible from Infomed, including articles on the topic written in Spanish and English, using DeCS and MeSH descriptors.
Results: Cancer of the lower third of the rectum signifies a fundamental change for the surgeon. Abdominoperineal resection has been considered as the gold standard for the treatment of adenocarcinomas located in the middle and lower rectum. However, with increased knowledge of the disease, the development of surgical techniques, better instrumentation, and the use of preoperative radiochemotherapy, a change has been achieved in treating rectal cancer, which goes from abdominoperineal resection with permanent colostomy to conservative surgery of the sphincter using minimal invasive techniques.
Conclusions: The conservative surgery of the sphincters for rectal cancer by minimal invasive techniques is possible to be performed in most patients, with longterm results similar to those of the abdominoperineal resection.


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