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학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
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논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 발행연도
- 2018.1
- 수록면
- 703 - 716 (14page)
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Despite innovative advancements, the management of distally located rectal cancer (RC) remains a formidable endeavor. Thecritical location of the tumor predisposes it to a circumferential resection margin that tends to involve the sphincters and surroundingorgans, pelvic lymph node metastasis, and anastomotic complications. In this regard, colorectal surgeons should beaware of issues beyond the performance of total mesorectal excision (TME). For decades, abdominoperineal resection had beenthe standard of care for low-lying RC; however, its association with high rates of tumor recurrence, tumor perforation, and poorersurvival has stimulated the development of novel surgical techniques and modifications, such as extralevator abdominoperinealexcision. Similarly, difficult dissections and poor visualization, especially in obese patients with low-lying tumors, have led to thedevelopment of transanal TME or the “bottom-to-up” approach. Additionally, while neoadjuvant chemoradiotherapy has allowedfor the execution of more sphincter-saving procedures without oncologic compromise, functional outcomes remain an issue. Nevertheless, neoadjuvant treatment can lead to significant tumor regression and complete pathological response, permittingthe utilization of organ-preserving strategies. At present, an East and West dualism pervades the management of laterallymph node metastasis, thereby calling for a more global and united approach. Moreover, with the increasing importance of qualityof life, a tailored, individualized treatment approach is of utmost importance when taking into account oncologic and anticipatedfunctional outcomes.
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참고문헌 (87)
참고문헌 신청
Cravo M / 2014 / Management of rectal cancer: times they are changing / GE Port J Gastroenterol 21:192~200
Heald RJ / 1979 / A new approach to rectal cancer / Br J Hosp Med 22:277~281
Suwanabol PA / 2017 / Transanal total mesorectal excision: a novel approach to rectal surgery / Clin Colon Rectal Surg 30:120~129
Smith JJ / 2015 / Advances and challenges in treatment of locally advanced rectal cancer / J Clin Oncol 33:1797~1808
Taylor FG / 2011 / Preoperative high-resolution magnetic resonance imaging can identify good prognosis stage I, II, and III rectal cancer best managed by surgery alone: a prospective, multicenter, European study / Ann Surg 253:711~719
Heald RJ / 1979 / A new approach to rectal cancer / Br J Hosp Med 22:277~281
Suwanabol PA / 2017 / Transanal total mesorectal excision: a novel approach to rectal surgery / Clin Colon Rectal Surg 30:120~129
Smith JJ / 2015 / Advances and challenges in treatment of locally advanced rectal cancer / J Clin Oncol 33:1797~1808
Taylor FG / 2011 / Preoperative high-resolution magnetic resonance imaging can identify good prognosis stage I, II, and III rectal cancer best managed by surgery alone: a prospective, multicenter, European study / Ann Surg 253:711~719
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