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TitleRectal Cancer Surgery [electronic resource] : Optimisation โ{128}{148} Standardisation โ{128}{148} Documentation / edited by Odd Sรธreide, Jarle Norstein
ImprintBerlin, Heidelberg : Springer Berlin Heidelberg, 1997
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Descript XVI, 457p. 130 illus. online resource


Rectal cancer is a major killer. Most of those dying after curative surgery suffer from recurrent disease in the pelvis. Local recurrence is also the only site of failure in up to 50% of patients. A disturbing fact is that the local recurrence rate shows considerably surgeon-related variances. There is now strong evidence that optimizing surgical technique by adopting the principle of total mesorectal excision (TME) will reduce local failure rate, increase the use of sphincter-saving operations, and improve functional results. Surgeons applying this surgical principle will consistently achieve similarly low recurrence rates. This book * reviews the failure patterns after rectal cancer surgery, * discusses the anatomical basis for rectal cancer surgery, * documents the method of spread with emphasis on lymph node metastasis, * describes conventional and optimal surgery, * presents methods of pathological evaluation of the specimen, * documents functional results of and organizational factors influencing rectal cancer treatment. The role of adjuvant therapy, if surgery is optimized, is critically reviewed. In the final chapter, an international documentation system is presented


Rectal Cancer โ{128}{148} Natural History of the Disease -- 1 Cancer of the Rectum: Epidemiology, Improvement in Survival and the Role of a National Cancer Registry -- 2 Results of Rectal Cancer Treatment: A National Experience -- 3 Failure After Curative Surgery Alone -- Tumour Staging -- 4 Staging Systems โ{128}{148} A Review -- 5 Limitations of Existing Systems of Staging for Rectal Cancer: The Forgotten Margin -- 6 Preoperative Staging: A Critical Analysis -- 7 Potential of Molecular Biology in Preoperative Evaluation -- The Anatomical Basis for Rectal Cancer Surgery -- 8 Rectal and Pelvic Anatomy with Emphasis on Anatomical Layers -- 9 Regional Anatomy of the Male Pelvic Nerve Plexus: Composition, Divisions and Relationship to the Lymphatics -- 10 Anatomical Basis of Total Mesorectal Excision and Preservation of the Pelvic Autonomic Nerves in the Treatment of Rectal Cancer -- Tumour Spread As a Basis for Rectal Cancer Surgery -- 11 Spread of Rectal Carcinomas -- 12 Importance of Lymphatic Spread -- 13 The Lymphatic Spread of Rectal Cancer and the Effect of Dissection: Japanese Contribution and Experience -- Surgical Technique โ{128}{148} Options -- 14 Surgical Options in Rectal Cancer -- 15 Total Mesorectal Excision: History and Anatomy of an Operation -- 16 Total Mesorectal Excision with Pelvic Autonomic Nerve Preservation in the Operative Treatment of Rectal Carcinoma -- 17 Nerve-Sparing Surgery: Surgical Neuroanatomy and Techniques -- 18 Lateral Node Dissection โ{128}{148} A Critique -- 19 Laparoscopic Approaches to Malignant Disease -- 20 Laparoscopic Resection of Rectal Cancer: Short and Long Term Results -- Reconstruction -- 21 Straight Colorectal and Coloanal Anastomosis -- 22 The Pelvic Pouch -- 23 Colonic J-Pouch or Straight Anastomosis in Low Anterior Resection for Rectal Carcinoma? -- 24 Role of a Protecting Stoma After Rectal Resection for Cancer -- Outcome -- 25 Functional Results Following Rectal Surgery: A Review -- 26 The Effect of Specialization or Organization of Rectal Cancer Surgery -- 27 Surgery for Rectal Cancer: The Relationship Between Treatment Volume and Results -- The Role of Adjuvant Treatment if Surgery Is Optimal -- 28 Role of Radiotherapy in Addition to Optimal Surgery -- 29 Adjuvant Therapy for Rectal Cancers When Surgical Therapy Is Optimal -- 30 The Role of Adjuvant Treatment if Surgery Is Optimal: A Clinical Epidemiologistโ{128}{153}s View -- International Standardization and Research Strategies -- 31 International Standardization and Documentation of the Treatment of Rectal Cancer

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