Restorative Procedures

  • J. W. Milsom
  • H.-J. Cho


Rectal cancer is a common malignancy in the USA and, by itself (apart from cancer of colon), ranks sixth among intestinal malignancies [1[. DespIte expanding interest in chemotherapy and radiation therapy for the management of rectal cancer, surgical efforts remain the foundation of nearly all curative therapy. Applying the most advanced surgical principles, the surgeon now has the opportunity to excise completely most rectal cancers and give the majority of patients the possibility of anal sphincter preservation and relatively normal bowel and pelvic function.


Rectal Cancer Pelvic Floor Anal Sphincter Abdominoperineal Resection Inferior Mesenteric Artery 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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  1. 1.
    Böhm B, Parker S.L., Tong T, Bolden S. Cancer statistics 1997. CA Cancer J Clin 1997;47:5.CrossRefGoogle Scholar
  2. 2.
    Heald R.J., Smedh R.K., Kald A, Sexton R, Moran B.J. Abdominoperineal excision of the rectum: an endangered operation. Dis Colon Rectum 1997;40:747.PubMedCrossRefGoogle Scholar
  3. 3.
    Parks A.G. Benign tumors of rectum. In: Rob C, Smith R., Morgan C.N., editors. Clinical surgery: abdomen and rectum and anus. 2nd ed. London: Butterworths, 1966:541.Google Scholar
  4. 4.
    Bohm B, Milsom J.W., Kitago K, Brand M, Fazio V.W. Laparoscopic oncologic total abdominal colectomy with intraperitoneal stapled anastomosis in a canine model. J Laparosc Surg 1994;4:23.CrossRefGoogle Scholar
  5. 5.
    Bohm B, Milsom J.W., Kitago K, Brand M, Stolfi V.M., Fazio V.W. Use of laparoscopic techniques in oncologic right colectomy in a canine model. Ann Surg Oncol 1995;2:6.PubMedCrossRefGoogle Scholar
  6. 6.
    Milsom J.W., Bohm B, Decanini C, Fazio V.W. Laparoscopic oncologic proctocosigmoidectomy with low colorectal anastomosis in a cadaver model. Surg Endosc 1994;8:1117.PubMedCrossRefGoogle Scholar
  7. 7.
    Decanini C, Milsom J.W., Bohm B, Fazio V.W. Laparoscopic oncologic abdominoperineal resection. Dis Colon Rectum 1994;37:552.PubMedCrossRefGoogle Scholar
  8. 8.
    Turnbull R.B., Cuthbertson A. Abdominorectal pull-through resection for cancer and for Hirschsprung’s disease. Cleve Clin Q 1961;28:109.PubMedGoogle Scholar
  9. 9.
    Cutait D.E., Figliolini F.J. A new method of colorectal anastomosis in abdominoperineal resection. Dis Colon Rectum 1961;4:335.PubMedCrossRefGoogle Scholar
  10. 10.
    Miles W.E. A method of performing abdomino-perineal excision for carcinoma of the rectum and of the terminal portion of the pelvic colon. Lancet 1908;ii:1812.CrossRefGoogle Scholar
  11. 11.
    Moynihan B.G.A. The surgical treatment of cancer of the sigmoid flexure and rectum. Surg Gynecol ObstetGoogle Scholar
  12. 12.
    Gordon W.C., Dukes C. The treatment of carcinoma of the rectum with radium with an introduction in the spread of cancer of the rectum. Br J Surg 1930;17:643.CrossRefGoogle Scholar
  13. 13.
    Gabriel W.B., Dukes C., Bussey F.U. Lymphatic spread of cancer of the rectum. Br J Surg 1935;23:395.CrossRefGoogle Scholar
  14. 14.
    Goligher J.C. The blood supply of the sigmoid colon and rectum. Br J Surg 1949;37:157.PubMedCrossRefGoogle Scholar
  15. 15.
    Bacon H.F., Dirbas F., Myers T.B., et al. Extensive lymphadenectomy and high ligation of the inferior mesenteric artery for carcinoma of the left colon and rectum. Dis Colon Rectum 1958;1:457.PubMedCrossRefGoogle Scholar
  16. 16.
    Sugarbaker P.H., Corlew S. Influence of surgical techniques on survival in patients with colorectal cancer: a review. Dis Colon Rectum 1982;25:545.PubMedCrossRefGoogle Scholar
  17. 17.
    Grinnel R.S., Hint R.B. Ligation of inferior mesenteric artery at the aorta in resection for carcinoma of the sigmoid and rectum. Surg Gynecol Obstet 1952;94:526.Google Scholar
  18. 18.
    Grinnel R.S. Results of ligation of the inferior mesenteric artery at the aorta in resections of carcinoma of the descending and sigmoid colon and rectum. Surg Gynecol Obstet 1965;120:1031.Google Scholar
  19. 19.
    Pezim M.E., Nicholls R.J. Survival after high or low ligation of the inferior mesenteric artery during curative surgery for rectal cancer. Ann Surg 1984;200:729.PubMedCrossRefGoogle Scholar
  20. 20.
    Surtees P, Ritchie J.K., Phillips R.K.S. High versus low ligation of the inferior mesenteric artery in rectal cancer. Br J Surg 1990;77:618.PubMedCrossRefGoogle Scholar
  21. 21.
    Mayo W.J. The radical operation for cancer of the rectum and rectosigmoid. Trans Am Surg Assoc 1916; 34:261.Google Scholar
  22. 22.
    Dixon C.F. Anterior resection for malignant lesions of the upper part of the rectum and lower part of the sigmoid. Ann Surg 1948;128:425.PubMedCrossRefGoogle Scholar
  23. 23.
    Best R.R., Blair J.B. Sphincter preserving operations for rectal carcinoma as related to the anatomy of the lymphatics. Ann Surg 1949;128:425.Google Scholar
  24. 24.
    Goligher J.C., Dukes C.E., Bussey H.J.R. Local recurrence after sphincter saving excisions for carcinoma of the rectum and rectosigmoid. Br J Surg 1951;39:119.CrossRefGoogle Scholar
  25. 25.
    Williams N.S., Durdey P., Johnston D. The outcome following sphincter-saving, resection and abdomino-perineal resection for low rectal cancer. Br J Surg 1985;72:595.PubMedCrossRefGoogle Scholar
  26. 26.
    Pollett W.G., Nicholls R.J. The relationship between the extent of distal clearance and survival and local recurrence rates after curative anterior resection for carcinoma of the rectum. Ann Surg 1983;198:159.PubMedCrossRefGoogle Scholar
  27. 27.
    Weese J.L., O’Grady M.G., Ottery F.D. How long is the five centimeter margin? Surg Gynecol Obstet 1986;163:101.PubMedGoogle Scholar
  28. 28.
    Phillips R.K.S., Hittinger R., Blesovsky L., Fry J.S., Fielding L.P. Local recurrence following “curative” surgery for large bowel cancer: II. The rectum and rectosigmoid. Br J Surg 1984;71:17.PubMedCrossRefGoogle Scholar
  29. 29.
    Pilipshen R.J., Heiliveil M, Quan S.H.Q., Sternberg S.S., Enker W.E. Patterns of pelvic recurrence following definitive resections of rectal cancer. Cancer 1984;53: 1354.PubMedCrossRefGoogle Scholar
  30. 30.
    Rao A.R., Kazan A.R., Chan P.M., Gilbert H.A., Nusebaum H., Hintz B.L. Patterns of recurrence following curative resection alone for adenocarcinoma of the rectum and sigmoid colon. Cancer 1981;48:1492.PubMedCrossRefGoogle Scholar
  31. 31.
    Case A.W., Millior R.R., Pfaff W.W. Patterns of recurrence following surgery alone for adenocarcinoma of the colon and rectum. Cancer 1976;37:2861.CrossRefGoogle Scholar
  32. 32.
    Quirke P, Dundey P, Dixon M.F., Williams N.W. Local recurrence of rectal adenocarcinoma due to inadequate surgical resection. Lancet 1986;i:996.CrossRefGoogle Scholar
  33. 33.
    Heald R.J., Husband E.M., Ryall R.D.H. The mesorectum in rectal cancer surgery: the clue to pelvic recurrence? Br J Surg 1982;69:613.PubMedCrossRefGoogle Scholar
  34. 34.
    Hojo K, Savada T, Moriya Y. An analysis of survival, voiding and sexual function after wide ileopelvic lymphadenectomy in patients with carcinoma of the rectum, compared with conventional lymphadenectomy. Dis Colon Rectum 1989;32:128.PubMedCrossRefGoogle Scholar
  35. 35.
    Heald R.J., Ryall R.D.H. Recurrence and survival after total mesorectal excision for rectal cancer. Lancet 1986;i:1479.CrossRefGoogle Scholar
  36. 36.
    Lavery I.C., Lopez-Kostner F, Fazio V.W., Fernandez-Martin M., Milsom J.W., Church J.M. Chances of cure are not compromised with sphincter-saving procedures for cancer of the lower third of the rectum. Surgery 1997;122:779.PubMedCrossRefGoogle Scholar
  37. 37.
    Enker W.E., Heiliveil M.L., Hertz R.E.L., et al. En bloc pelvic lymphadenectomy and sphincter preservation in the surgical management of rectal cancer. Ann Surg 1986;203:426.PubMedCrossRefGoogle Scholar
  38. 38.
    Pittman M.R., Thornton H, Ellis H. Survival after extended resection for locally advanced carcinomas of the colon and rectum. Ann R Coli Surg Engl 1984;66:81.Google Scholar
  39. 39.
    Orkin B.A., Dozois R.I.Z., Beart R.W., et al. Extended resection for locally advanced primary adenocarcinoma of the rectum. Dis Colon Rectum 1989;32:286.PubMedCrossRefGoogle Scholar
  40. 40.
    Boey J, Wong I. Pelvic exenteration for locally advanced colorectal carcinoma. Ann Surg 1982;195:513.PubMedCrossRefGoogle Scholar
  41. 41.
    Bonfanti G, Bozzetti F, Fori R, et al. Results of extended surgery for cancer of the rectum and sigmoid. Br J Surg 1982;69:305.PubMedCrossRefGoogle Scholar
  42. 42.
    Wanebo H.J., Gaber D.L., Whitehall R, Morgan R.F., Constable W.C. Pelvic recurrence of rectal cancer: options for curative resection. Ann Surg 1987;205:482.PubMedCrossRefGoogle Scholar
  43. 43.
    Sugarbaker P.H. Partial sacrectomy for en bloc excision of rectal cancer with posterior fixation. Dis Colon Rectum 1982;26:208.Google Scholar
  44. 44.
    John T.G., Garden O.J. Laparoscopic ultrasonography: extending the scope of diagnostic laparoscopy. Br J Surg 1994;81:5.PubMedCrossRefGoogle Scholar
  45. 45.
    Marchesa P., Milsom J.W., Hale J.C., O’Malley C.M., Fazio V.W. Intraoperative laparoscopic liver ultrasonography for staging of colorectal cancer. Initial experience. Dis Colon Rectum 1996;39:S73.PubMedCrossRefGoogle Scholar
  46. 46.
    Havenga K, DeRuiter M.C., Enker W.E., Welvaart K. Anatomical basis of autonomic nerve-preserving total mesorectal excision for rectal cancer. Br J Surg 1996;83:384.PubMedCrossRefGoogle Scholar
  47. 47.
    Beard J.D., Nicholson M.L., Sayers R.D., Lloyd D., Everson N.W. The intraoperative air testing of colorectal anastomosis: a prospective randomized trial. Br J Surg 1990;77:1095.PubMedCrossRefGoogle Scholar
  48. 48.
    Bacon B.E. Evolution of sphincter muscle preservation and reestablishment of continuity in the operative treatment of rectal and sigmoid cancer. Surg Gynecol Obstet 1945;181:113.Google Scholar
  49. 49.
    Lazorthes F., Fages P, Chiotasso P, Lemozy J, Bloom E. Resection of the rectum with construction of a colonic reservoir and coloanal anastomosis for carcinoma of the rectum. Br J Surg 1976;73:136.CrossRefGoogle Scholar
  50. 50.
    Heimann T.M., Szporn A., Bolnick K., Aufses A.H. Jr. Local recurrence following surgical treatment of rectal cancer: comparison of anterior and abdominoperineal resection. Dis Colon Rectum 1986;29:862.PubMedCrossRefGoogle Scholar
  51. 51.
    Morson B.C., Vaughn E.G., Bussey H.J.R. Pelvic recurrence after excision of rectum for carcinoma. BMJ 1963;ii:13.CrossRefGoogle Scholar
  52. 52.
    McDermott F, Hughes E, Pihl E, Milne J, Price A. Long term results of restorative resection and total excision for carcinoma of the middle third of the rectum. Surg Gynecol Obstet 1982;154:833.PubMedGoogle Scholar
  53. 53.
    Rich T., Gunderson L., Galdibini J.J., Cohen A.M., Donaldson G. Patterns of recurrence of rectal cancer after potentially curative surgery. Cancer 1983;52:1317.PubMedCrossRefGoogle Scholar
  54. 54.
    Williams N.S., Johnston D. Survival and recurrence after sphincter saving resection and abdominoperineal resection for carcinoma of the middle third of the rectum. Br J Surg 1984;71:278.PubMedCrossRefGoogle Scholar
  55. 55.
    Amato A, Pescatori M, Butti A. Local recurrence following abdominal/perineal excision and anterior Modern Management of Cancer of the Rectum resection for rectal carcinoma. Dis Colon Rectum 1991;34:317.PubMedCrossRefGoogle Scholar
  56. 56.
    Dixon A.R., Maxwell W.A., Thornton Holmes J. Carcinoma of the rectum: a 10-year experience. Br J Surg 1991;78:308.PubMedCrossRefGoogle Scholar
  57. 57.
    Michelassi F, Vannucci L, Ayala J.J., et al. Local recurrence after curative resection of colorectal adenocarcinoma. Surgery 1990;108:787.PubMedGoogle Scholar
  58. 58.
    Macfarlane J.K., Ryall R.D.H., Heald R.J. Mesorectal excision for rectal cancer. Lancet 1993;341:457.PubMedCrossRefGoogle Scholar
  59. 59.
    Milsom J.W., Bohm B, Hammerhofer K.A., Fazio V.W., Steiger E, Elson P. A prospective, randomized trial comparing laparoscopic versus conventional techniques in colorectal cancer surgery: a preliminary report. J Am Coli Surg 1998;187:46.CrossRefGoogle Scholar

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© Springer-Verlag London 2001

Authors and Affiliations

  • J. W. Milsom
  • H.-J. Cho

There are no affiliations available

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