Posterior-First Two-Stage Approach to En Bloc Resection of Locally Recurrent Rectal Cancer Involving the Pelvic Sidewall. Issue 8 (August 2021)

• Record Type: Journal Article
• Authors: Sakata, Shinichiro; Karim, S. Mohammed; Mathis, Kellie L.; Kelley, Scott R.; Rose, Peter S.; Dozois, Eric J.
• Is Part Of: Diseases of the colon & rectum. Volume 64:Issue 8(2021)
• Publication Date: 2021-08
• Subjects: Anterior -- Exenteration -- Negative margins -- Posterior -- Recurrent rectal cancer -- Technique; Colon (Anatomy) -- Diseases -- Periodicals; Rectum -- Diseases -- Periodicals; Colonic Diseases -- Periodicals; Colorectal Surgery -- Periodicals; 616.34
• DOI: 10.1097/DCR.0000000000002091
• Languages: English
• ISSNs: 0012-3706

Abstract

Abstract : INTRODUCTION: Using standard anterior-only or anterior then posterior approaches can make an R0 resection difficult to achieve in patients with pelvic sidewall recurrences because of confined working spaces and poor visibility. TECHNIQUE: Given the limitations of standard approaches, we have used a novel posterior-first then anterior 2-stage approach allowing us to widely expose and secure deep margins and control vessels under direct visualization. RESULTS: We present a technical note describing this approach in patients with recurrent rectal cancer involving the pelvic sidewall with extrapelvic extension. CONCLUSION: The posterior-first approach may assist in achieving a higher number of R0 resections in patients with locally recurrent rectal cancer involving the pelvic sidewall.