Abstract
The incidence of rectal cancer remains high – there are 13,000 new cases each year in the United Kingdom (population 60 million). A small proportion of these cases will present with direct posterior invasion of the tumour with involvement of the sacrum. Moreover, 5–15 % of patients who undergo resection with intent to cure will develop local recurrence of their tumour. Such recurrences may involve the neorectum ± the adjacent genito-urinary organs, the pelvic sidewall, the sacrum or a combination of these three sites. There is, therefore, a small but definite cohort of patients with either primary or recurrent rectal cancer with sacral involvement. Those suitable for resection need careful preoperative assessment and a well thought-out and executed surgical strategy.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Further Reading
Mirnezami A, Sagar PM, Kavanagh D, Witherspoon P, Lee P, Winter D. Clinical algorithms for the surgical management of locally recurrent rectal cancer. Dis Colon Rectum. 2010;53(9):1248–57.
Moriya Y, Akasu T, Fujita S, Yamamoto S. Total pelvic exenteration with distal sacrectomy for fixed recurrent rectal cancer in the pelvis. Dis Colon Rectum. 2004;47:2047–53.
Boyle KM, Sagar PM, Chalmers AG, Sebag-Montefiore D, Cairns A, Eardley I. Surgery for locally recurrent rectal cancer. Dis Colon Rectum. 2005;48:929–37.
Heriot AG, Byrne CM, Dobbs B, Tilney H, Solomon MJ, Mackay J, Frizelle F. Extended radical resection: the choice for locally recurrent rectal cancer. Dis Colon Rectum. 2008;51:284–91.
Suzuki M, Dozois RR, Devine RM, Nelson H, Weaver AL, Gunderson LL, Ilstrup DM. Curative reoperations for locally recurrent rectal cancer. Dis Colon Rectum. 1996;39:730–6.
Moore HG, Shoup M, Riedel E, Minsky BD, Alektiar KM, Ercolani M, Paty PB, Wong WD, Guillem JG. Colorectal cancer pelvic recurrences: determinants of resectability. Dis Colon Rectum. 2004;47:1599–606.
Sagar PM, Gonsalves S, Heath RM, Phillips N, Chalmers AG. Composite abdominosacral resection for recurrent rectal cancer. Br J Surg. 2009;96:191–6.
Austin KK, Solomon MJ. Pelvic exenteration with en bloc iliac vessel resection for lateral pelvic wall involvement. Dis Colon Rectum. 2009;52:1223–33.
Bell SW, Dehni N, Chaouat M, Lifante JC, Parc R, Tiret E. Primary rectus abdominis myocutaneous flap for repair of perineal and vaginal defects after extended abdominoperineal resection. Br J Surg. 2005;92:482–6.
Miles WK, Chang DW, Kroll SS, Miller MJ, Langstein HN, Reece GP, Evans GR, Robb GL. Reconstruction of large sacral defects following total sacrectomy. Plast Reconstr Surg. 2000;105:2387–94.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2017 Springer-Verlag Berlin Heidelberg
About this chapter
Cite this chapter
Sagar, P.M. (2017). Surgical Technique and Difficult Situations from Peter M. Sagar (Conventional, Abdomino-Sacral Resection). In: Korenkov, M., Germer, CT., Lang, H. (eds) Gastrointestinal Operations and Technical Variations. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-49878-1_47
Download citation
DOI: https://doi.org/10.1007/978-3-662-49878-1_47
Published:
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-662-49876-7
Online ISBN: 978-3-662-49878-1
eBook Packages: MedicineMedicine (R0)