Complications of elective surgery for rectal cancer

Abstract

BACKGROUND: Standardization of surgery and new procedures have led to significant advances in the treatment of rectal cancer. METHODS: Review on avoidance and management of complications in rectal cancer surgery. RESULTS: Anatomical dissection of the mesorectum permits optimal local control and reduction of local recurrence. Sphincter preservation can be achieved by the technique of intersphincteric resection even for low tumours. A J-pouch or a recently designed coloplasty pouch improve functional results after coloanal anastomoses. Neoadjuvant treatments have a role in local control of the disease after TME surgery and in new strategies of sphincter-saving procedures. Although perioperative morbidity in elective surgery for rectal cancer is very low, radical local control of the disease and the patient's wish for sphincter preservation have to be weighed against possible complications. The literature was carefully reviewed to evaluate data on the procedure-specific complications in elective surgery for rectal cancer and the impact of neoadjuvant treatment regimens and perioperative management on postoperative morbidity. CONCLUSIONS: Meticulous attention to detail achieve low complication rates in modern rectal surgery. In experienced hands, the total mesorectal excision operation is not associated with increased postoperative morbidity and mortality.