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J.Jpn. Surg. Soc.. 106(4): 302-305, 2005


Feature topic

SELECTION AND TECHNIQUES OF SURGICAL PROCEDURES BASED ON THE MODE OF CANCER SPREAD OF RECTAL CANCER

Division of Colorectal Surgery, National Cancer Center Hospital, Tokyo, Japan

Yoshihiro Moriya

The author reviewed recent results of Japanese and international studies on preoperative staging, pathology of bisopied specimens, sentinel node navigation surgery, and single tumor cells in rectal cancer. Preoperative staging with high accuracy is possible using high spatial MRI imaging. Examination of circumferential resection margins is incompatible with that of lymph nodes. Intersphincteric resection can be an alternative to abdominoperineal resection for selected rectal tumors located at the anorectal junction without compromising the chance for cure. Although information on sentinel node navigation surgery and isolated single cells has accumulated, the selection of surgical procedures should not be based on these investigations. We emphasize that multiinstitutional clinical trials of adjuvant chemoradiotherapy and surgical treatment are indispensable for developing treatments for rectal cancer in Japan.


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