Difficulties and strategies of total mesorectal excision for middle and low rectal cancer after neoadjuvant therapy
10.3760/cma.j.cn115610-20230425-00185
- VernacularTitle:中低位直肠癌新辅助治疗后全系膜切除术的难点与对策
- Author:
Jianfeng ZHANG
1
;
Bin YU
;
Zhenya ZHANG
;
Guiying WANG
Author Information
1. 河北医科大学第四医院外二科，石家庄 050011
- Keywords:
Rectal neoplasms;
Local advanced;
Neoadjuvant chemoradiotherapy;
Total mesorectal excision;
Difficulties;
Strategies
- From:
Chinese Journal of Digestive Surgery
2023;22(6):724-728
- CountryChina
- Language:Chinese
-
Abstract:
Patients with local advanced rectal cancer (LARC) can benefit from neoadju-vant chemoradiotherapy (nCRT) of reducing local recurrence rate and improving survival rate. However, tissue edema after nCRT may lead to unclear tissue spaces, making it challenging for lymph node dissection and nervous system protection. The difficulty in locating inferior margin of tumor after clinical complete remission or closing to clinical complete remission, as well as the increasing risk of anastomotic leakage after nCRT, pose difficulties and new challenges of total mesorectal excision for middle and low rectal cancer. Based on literatures and clinical experiences, the authors summarize the difficulties and strategies of total mesorectal excision after nCRT, in order to provide reference for colleagues.
