Copyright ©2008 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Jun 7, 2008; 14(21): 3281-3289
Published online Jun 7, 2008. doi: 10.3748/wjg.14.3281
Surgical treatment for rectal cancer: An international perspective on what the medical gastroenterologist needs to know
Rolv-Ole Lindsetmo, Yong-Geul Joh, Conor P Delaney
Rolv-Ole Lindsetmo, Department of Gastrointestinal Surgery, University Hospital of North Norway and Institute of Clinical Medicine, University of Tromsø, Tromsø N-9036, Norway
Yong-Geul Joh, Department of Surgery, Hansol Hospital, Seoul 138-844, South Korea
Conor P Delaney, Division of Colorectal Surgery, University Hospital Case Medical Center, Cleveland, Ohio 44106-5047, United States
Author contributions: Lindsetmo RO wrote the paper; Joh YG and Delaney CP made critical revisions and additions to the manuscript.
Correspondence to: Conor P Delaney, MD, PhD, Division of Colorectal Surgery, University Hospitals Case Medical Center, 11100 Euclid Avenue, Cleveland, Ohio 44106-5047, United States. conor.delaney@uhhospitals.org
Telephone: +1-216-8448087
Fax: +1-216-8445957
Received: February 21, 2008
Revised: April 15, 2008
Accepted: April 22, 2008
Published online: June 7, 2008

Rectal cancer accounts for one third of all colorectal cancers. The age adjusted death rates from colorectal cancer have declined over recent decades due to a combination of colorectal cancer screening, improved diagnostic tests, improved standardized surgical technique, improved medical support, neoadjuvant chemotherapies and radiation treatment or combinations of these. Because of complex treatment algorithms, use of multidisciplinary teams in the management of rectal cancer patients has also been popularized. Medical gastroenterologists performing colonoscopies are frequently the first health care provider to raise the suspicion of a rectal cancer. Although the diagnosis depends on histological confirmation, the endoscopic presentation is almost diagnostic in many cases. In order to meet the patient’s immediate needs for information, it is important that the endoscopist has knowledge about the investigations and treatment options that will be required for their patient. The aim of this paper is to describe the modern preoperative investigations and operative procedures commonly offered to rectal cancer patients taking into account perspectives of three colorectal surgeons, practicing in the USA, Europe and Asia.

Keywords: Rectal cancer management, Evaluation, Staging, Neoadjuvant, Adjuvant, Surgical treatment, Surveillance