The role of surgery in the loco-regional control of adenocarcinoma of the rectum is being increasingly challenged by the good response rates of neoadjuvant oncological treatment. This review represents an opinion paper outlining well-established choices and new trends in surgical intervention, unresolved difficulties of local and regional staging of rectal malignancy and accurate assessment of tumour response to preoperative downstaging chemoradiation. The influence of preoperative chemoradiation on subsequent surgical strategy is discussed highlighting several controversial aspects of surgical management both when the tumour fails to respond and appears to be irresectable and when complete clinical response is observed.
机构:
Washington Univ, Sch Med, Dept Surg, Div Colon & Rectal Surg, St Louis, MO 63110 USAWashington Univ, Sch Med, Dept Surg, Div Colon & Rectal Surg, St Louis, MO 63110 USA
Chen, Ina
Glasgow, Sean C.
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Washington Univ, Sch Med, Dept Surg, Div Colon & Rectal Surg, St Louis, MO 63110 USAWashington Univ, Sch Med, Dept Surg, Div Colon & Rectal Surg, St Louis, MO 63110 USA
机构:
Thomas Jefferson Univ, Dept Surg, Div Colon & Rectal Surg, Philadelphia, PA 19107 USAThomas Jefferson Univ, Dept Surg, Div Colon & Rectal Surg, Philadelphia, PA 19107 USA
Harris, Lisa J.
Phillips, Benjamin R.
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Thomas Jefferson Univ, Dept Surg, Div Colon & Rectal Surg, Philadelphia, PA 19107 USAThomas Jefferson Univ, Dept Surg, Div Colon & Rectal Surg, Philadelphia, PA 19107 USA
Phillips, Benjamin R.
Maxwell, Pinckney J.
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Thomas Jefferson Univ, Dept Surg, Div Colon & Rectal Surg, Philadelphia, PA 19107 USAThomas Jefferson Univ, Dept Surg, Div Colon & Rectal Surg, Philadelphia, PA 19107 USA
Maxwell, Pinckney J.
Isenberg, Gerald A.
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Thomas Jefferson Univ, Dept Surg, Div Colon & Rectal Surg, Philadelphia, PA 19107 USAThomas Jefferson Univ, Dept Surg, Div Colon & Rectal Surg, Philadelphia, PA 19107 USA
Isenberg, Gerald A.
Goldstein, Scott D.
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Thomas Jefferson Univ, Dept Surg, Div Colon & Rectal Surg, Philadelphia, PA 19107 USAThomas Jefferson Univ, Dept Surg, Div Colon & Rectal Surg, Philadelphia, PA 19107 USA
机构:
Canc Inst Hosp, Japanese Fdn Canc Res, Dept Surg Gastroenterol, Gastroenterol Ctr, Tokyo, JapanTeikyo Univ, Sch Med, Dept Surg, Itabashi Ku, Tokyo 1738605, Japan
Akiyoshi, Takashi
Kobunai, Takashi
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Teikyo Univ, Sch Med, Dept Surg, Itabashi Ku, Tokyo 1738605, JapanTeikyo Univ, Sch Med, Dept Surg, Itabashi Ku, Tokyo 1738605, Japan
Kobunai, Takashi
Watanabe, Toshiaki
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Teikyo Univ, Sch Med, Dept Surg, Itabashi Ku, Tokyo 1738605, Japan
Univ Tokyo, Dept Surg Oncol, Bunkyo Ku, Tokyo 1138655, JapanTeikyo Univ, Sch Med, Dept Surg, Itabashi Ku, Tokyo 1738605, Japan