Download Low rectal cancer – diagnosis and therapeutic problems Authors

Low rectal cancer – diagnosis and therapeutic problems
Authors: Surlin V, Patrascu S, Radulescu D, Bica M, Margaritescu D, Georgescu I
Introduction: Colorectal cancer is one of the most frequent cancers being the second
cause of death in western countries, lately found more and more often in young ages.
Material and method: 59 patients with low rectal cancer admitted to our clinic between 2005 and
2016 were studied. We followed the difficulties encountered in the diagnosis of the disease and
also the therapeutic management of these patients.
Results : The therapeutic strategy in low rectal cancer consists in a multidisciplinary
treatment with radiotherapy, chemotherapy and surgery. For the patients in our study the
radical surgical treatment was in conformity with existing therapeutic protocols that
require en block resection of the tumor, rectum, mesorectum and lymph nodes. In our
study, although 2/3 of patients presented with complicated low rectal cancer, for most
cases (86%) a radical procedure was performed. For 19 patients we performed the Miles
procedure and for 12 patients – ultralow resections. Local complications were observed in
14 cases (anastomotic leak, rectovaginal fistula, wound infection).
Conclusion: Elctive treatment in low rectal cancer consists in en block resection of the
rectum, mesorectum and lymph nodes dissection. Preoperative radiotherapy is required.
Rectal cancer surgery is still associated with high postoperative morbidity. Early
diagnosis of rectal cancer is very difficult, most patients presenting in advanced stages of
disease.