Role of local excision in the treatment of rectal cancer.

D. Rothenberger, J. García-Aguilar
{"title":"Role of local excision in the treatment of rectal cancer.","authors":"D. Rothenberger, J. García-Aguilar","doi":"10.1002/SSU.7","DOIUrl":null,"url":null,"abstract":"Local excision (LE) of properly selected rectal cancers can provide long-term survival, with minimal morbidity, negligible mortality, and excellent functional results. The role of LE has evolved over the past century. Initially, to avoid the excessive mortality of abdominal surgery, aggressive LE was performed to control the symptoms of rectal cancer. As abdominal surgery became safer, LE was restricted for use in palliation or high-risk patients. Better preoperative tumor staging resulted in an expanded role for LE, including curative-intent treatment of selected T(1-2) rectal cancers. Techniques for LE include snare polypectomy, transanal excision, transanal endoscopic microsurgery, and posterior approaches. The high local recurrence rate and compromised survival reported in modern series, despite efforts to properly select patients with cancers suitable for LE, have convinced the authors to restrict the use of curative-intent LE in good-risk patients only to the most favorable rectal cancers. Close follow-up after LE is critical, because radical surgical salvage is usually possible if recurrence is identified promptly. Whether adjuvant chemoradiation can expand the role of curative intent LE remains controversial.","PeriodicalId":77390,"journal":{"name":"Seminars in surgical oncology","volume":"2012 1","pages":"367-75"},"PeriodicalIF":0.0000,"publicationDate":"2000-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"71","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Seminars in surgical oncology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1002/SSU.7","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 71

Abstract

Local excision (LE) of properly selected rectal cancers can provide long-term survival, with minimal morbidity, negligible mortality, and excellent functional results. The role of LE has evolved over the past century. Initially, to avoid the excessive mortality of abdominal surgery, aggressive LE was performed to control the symptoms of rectal cancer. As abdominal surgery became safer, LE was restricted for use in palliation or high-risk patients. Better preoperative tumor staging resulted in an expanded role for LE, including curative-intent treatment of selected T(1-2) rectal cancers. Techniques for LE include snare polypectomy, transanal excision, transanal endoscopic microsurgery, and posterior approaches. The high local recurrence rate and compromised survival reported in modern series, despite efforts to properly select patients with cancers suitable for LE, have convinced the authors to restrict the use of curative-intent LE in good-risk patients only to the most favorable rectal cancers. Close follow-up after LE is critical, because radical surgical salvage is usually possible if recurrence is identified promptly. Whether adjuvant chemoradiation can expand the role of curative intent LE remains controversial.
局部切除在直肠癌治疗中的作用。
适当选择直肠癌的局部切除(LE)可提供长期生存,发病率最低,死亡率可忽略不计,功能效果良好。在过去的一个世纪里,LE的角色不断演变。最初,为了避免腹部手术的高死亡率,我们采用了积极的LE来控制直肠癌的症状。随着腹部手术变得更加安全,LE被限制用于姑息治疗或高危患者。更好的术前肿瘤分期导致LE的作用扩大,包括对选定的T(1-2)直肠癌的治疗意图治疗。治疗LE的技术包括圈套息肉切除术、经肛门切除术、经肛门内镜显微手术和后路手术。尽管努力选择适合LE的癌症患者,但现代系列报道的高局部复发率和低生存率使作者确信,将治疗目的LE限制在高危患者中仅用于最有利的直肠癌。LE后的密切随访至关重要,因为如果及时发现复发,通常可以进行根治性手术挽救。辅助放化疗是否能扩大治疗性LE的作用仍有争议。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
自引率
0.00%
发文量
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信