surgical management of locally recurrent rectal cancer局部复发性直肠癌手术管理.pdfVIP

Hindawi Publishing Corporation International Journal of Surgical Oncology Volume 2012, Article ID 464380, 6 pages doi:10.1155/2012/464380 Review Article Surgical Management of Locally Recurrent Rectal Cancer Niamh M. Hogan1, 2 and Myles R. Joyce2 1 Discipline of Surgery, National University of Ireland, Galway, Ireland 2 Department of Colorectal Surgery, University College Hospital, Galway, Ireland Correspondence should be addressed to Myles R. Joyce, myles.joyce@hse.ie Received 15 March 2012; Accepted 8 April 2012 Academic Editor: Ioannis Kanellos Copyright © 2012 N. M. Hogan and M. R. Joyce. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Developments in chemotherapeutic strategies and surgical technique have led to improved loco regional control of rectal cancer and a decrease in recurrence rates over time. However, locally recurrent rectal cancer continues to present considerable technical challenges and results in significant morbidity and mortality. Surgery remains the only therapy with curative potential. Despite a hostile intra-operative environment, with meticulous pre-operative planning and judicious patient selection, safe surgery is feasible. The potential benefit of new techniques such as intra-operative radiotherapy and high intensity focussed ultrasonography has yet to be thoroughly investigated. The future lies in identification of predictors of recurrence, development of schematic clinical algorithms to allow standardised surgical technique and further research into genotyping platforms to allow individualisation of therapy. This review highlights important aspe