Opinion Editorials represent the opinions of the authors and JAMA EDITORIAL and not those of the American Medical Association. Minimally Invasive Approaches to Rectal Cancer and Diverticulitis Does Less Mean More? Scott A. Strong, MD; Nathaniel J. Soper, MD Several advances have occurred in the field of colorectal mesorectal excision (TME), uninvolved CRM, and unin- surgery over the past 25 years, but 3 areas of noticeable volved distal resection margin. The North American study progress relate to appreciating an anatomical operative included patients (N = 486) with clinical stage II or III rectal approach to rectal cancer, understanding the natural course cancer treated with neoadjuvant therapy followed by mini- of diverticular disease, and adopting minimally invasive mally invasive (n = 240) or open (n = 222) proctectomy. strategies for large bowel disorders such as colon cancer and The Australasian study enrolled patients (N = 475) with 1,2 ulcerative colitis. clinical stage I-III rectal cancer who underwent laparoscopic The high local recurrence rates customarily accepted (n = 238) or open (n = 235) pelvic dissection; 50% received after curative resection of rectal cancer were challenged preoperative radiotherapy. when an association between the circumferential resection The technical quality of surgery in
JAMA – American Medical Association
Published: Oct 6, 2015
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