Should laparoscopic-assisted proctectomy be the standard of care for patients with resectable rectal cancer?

摘要

Cancer of the large intestine is often referred to as colorectal cancer. The problem with using the term 'colorectal' when referring to the large intestine is it fails to draw a distinction between the abdominal colon and the rectum. Those who routinely treat cancers of the colon and rectum will be the first to agree that the surgical approach and oncological priorities for colon and rectal cancer are different. For example, local-regional recurrence of cancer is much more prevalent when treating rectal cancer and likely reflects surgical technique [1,2]. High-quality surgical studies have found the rates of local recurrence for colon cancer to be in the order of 1% [3,4]. However, similar high-quality surgical studies have found rates of local recurrence of rectal cancer to vary between 5 and 30% [2,5,6]. In addition, rates of postoperative anastomotic leak for patients undergoing surgery for colon cancer differ from those of patients undergoing surgery for rectal cancer by a factor of 2-30 [7-9].