Surgery for rectal cancer (conventional open surgery)

Abstract

BACKGROUND: Discrepancy exists how to surgically approach rectal cancer (open or minimally invasive) and how to implement neoadjuvant oncological concepts into the treatment algorithm. METHODS: Analysis of the literature regarding the surgical treatment of rectal cancer. RESULTS: Oncological criteria (resection margin and lymphnode harvest) are equally met by the laparoscopic and open approach, when conducted in experienced centers. Due to the pelvic anatomy, the open approach seems to be advantageous for low rectal cancers, when compared to laparocopy. Total mesorectal excision should be reserved for low rectal cancers, tumors of the mid and proximal portion of the rectum should be treated by subtotal mesorectal excision. CONCLUSIONS: Laparoscopic rectal surgery can replace the open approach in the majority of the cases. Respective expertise is required to reproduce the excellent results of high volume centers.