Tech Coloproctol (2017) 21:577–579 DOI 10.1007/s10151-017-1661-5 CO NTRO VERS IES I N C OLO R ECTAL SUR GERY Looking for the Good, Bad and the Ugly rectal cancers of the twenty-ﬁrst century… or ‘‘How to avoid tears when peeling onions’’ R. Glynne-Jones Received: 28 June 2017 / Accepted: 29 June 2017 / Published online: 28 July 2017 Springer International Publishing AG 2017 The management of patients with ‘‘locally advanced rectal is convinced they have to avoid a permanent stoma, CRT cancer’’ (LARC) continues to evolve. Total mesorectal may again be justiﬁed. But CRT will render young ﬁt excision (TME) is the mainstay of curative treatment. patients infertile and cause adverse late effects. The longer Multiple randomised phase III trials showed that short- they survive, the worse will be the late effects of radiation. course preoperative radiotherapy (SCPRT) or chemoradi- Yet, if surgery does not entail a stoma and the patient ation (CRT) signiﬁcantly reduced the rates of local recur- receives CRT for an early cancer and does not achieve a rence compared to surgery alone [1–9]. Multidisciplinary CCR, then the CRT was an unnecessary additional burden, teams (MDTs) take corporate decisions together on the which will make urinary, sexual
Techniques in Coloproctology – Springer Journals
Published: Jul 28, 2017
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