Commentaries
Doing our best: surgery for rectal cancer
Correspondence to:
Dr M M Bertagnolli, Division of Surgical Oncology, Dana Farber/Brigham and Women’s Cancer Center, Brigham and Women’s Hospital, Boston, MA 02115, USA; mbertagnolli@partners.org
| The first 150 words of the full text of this article appear below. |
For resectable rectal cancer, surgical treatment must safely meet two objectives. The most important goal is to achieve an R0 tumour resection with adequate circumferential margins and a complete regional lymphadenectomy. A secondary objective is to optimise post-surgical quality of life by preserving anal sphincter function. Surgery for rectal cancer is technically demanding and requires sophisticated decision-making to achieve optimal results. How do we as a healthcare community achieve excellence in the performance of surgery for localised rectal cancer? Do quality indicators help achieve excellence, and if so, is the type of operation performed an effective quality indicator for surgery of localised rectal cancer?
Four operations encompass the majority of surgery for rectal cancer. Transanal excision is reserved for small, early stage distal tumours and is not the subject of this discussion. Anterior resection (AR) and Hartmann’s resection both involve excision of the tumour and entire mesorectum from an abdominal
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